BAPTISM

Name of Person Being Baptized *

First Name

Last Name

Birthday *

MM

DD

YYYY

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Primary Phone *

(###)

###

####

Secondary Phone

(###)

###

####

Mother's Name (if under age 18)

First Name

Last Name

Father's Name (if under age 18)

First Name

Last Name

Are you a member of FUMC *

Yes

No

Have you completed the Baptism Class? *

Yes

No

Date Completed

MM

DD

YYYY

Requested Date for Baptism

MM

DD

YYYY

Which Service?

10:00 AM

Would you like the pastor to be available after the service for pictures?

Yes

No