Ezekiel's Baptismal Information Form

INFORMATION OF PERSON BEING BAPTIZED

First Name

Middle Name

Last Name

Birthdate

Birthplace

Sex

Male Female

GUARDIAN INFORMATION (IF APPLICABLE)

Guardian 1

Phone

This address will receive a confirmation email

Address

Church Affiliation

Guardian 2

Phone

Address

Church Affiliation

SPONSOR INFORMATION

Sponsor

DATE REQUEST

We'll try our best to accomodate the dates you select.

1st Choice Date

2nd Choice Date

3rd Choice Date

OFFICE USE ONLY

Baptismal Date

Time

Description

Please fill out this form and click submit.