Baptism Scheduling Form

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I Performed This Baptism: __________________________

Approved by: ________ Notified: ________

(Pastor, please sign and return to the Membership Secretary)

BAPTISM CERTIFICATE INFORMATION Child’s Full Name: _____________________________________________________________ Child’s Date of Birth: ___________________________

Boy

Girl

City / State of Birth: ____________________

Mother’s Full Name: ________________________________________________________________________ Father’s Full Name: _________________________________________________________________________ Address: _______________________________________ Email: _____________________________________ City: ___________________________ State: _________ Zip: __________ Phone: _______________________ Siblings Name(s) & ages: _____________________________________________________________________ Date of Baptism: 1st Choice _____________________________________ 2nd Choice _______________________________ Members?

Yes

No

If No – CC Class?

Yes

Service of Worship: _________________ Baptism Class Date: ________________ No

Joining on: ________________

Comments: ________________________________________________________________________________ __________________________________________________________________________________________ Approved: Notified:

I Performed This Baptism: _____________________________

________ ________

(Pastor, please sign and return to the Membership Secretary)

BAPTISM CERTIFICATE INFORMATION Child’s Full Name: ______________________________________________________________ Boy Child’s Date of Birth: ___________________________

Girl

City / State of Birth: ____________________

Mother’s Full Name: ________________________________________________________________________ Father’s Full Name: _________________________________________________________________________ Address: ________________________________________ Email: ____________________________________ City: ___________________________ State: _________ Zip: __________ Phone: _______________________ Siblings Name(s) & ages: _____________________________________________________________________ Date of Baptism: 1st Choice _____________________________________

Service of Worship: _________________

2nd Choice _______________________________

Baptism Class Date: _________________

Members?

Yes

No

If No – CC Class?

Yes

No

Joining on: _________________

Comments: _________________________________________________________________________________