Name, Person To Be Baptized * First Name Last Name Name, Parent/Guardian, If Applicable First Name Last Name Email Phone * Your number is requested to set up a meeting to discuss the Baptism with a church Ministerial representative. (###) ### #### Date Requested for Baptism MM DD YYYY Which Service During which service would the person like to be baptized? First Service Second Service Name, Of The Person To Perform The Baptism First Name Last Name Name, Of The Person To Pray For The Baptism First Name Last Name Message We are very excited to help you with your new step in your walk with Christ. In the box below please let us know if you have any questions or if you want tell us a little about your decision. Thank you!