Baptism Application Once we receive your registration form, we will contact you to schedule your baptism. If you have any other questions or concerns regarding baptism, please contact us.Name* First Last Address Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Birth Date Date Format: MM slash DD slash YYYY Home PhoneCell PhoneEmail* Enter Email Confirm Email Please state briefly how and when you accepted Christ as your Savior*Why do you want to get baptized? Have you been baptized before (since becoming a Christian)?*Please select one*I am ready to schedule my baptism. (We will email you with available dates.)I need to speak with someone before I'm ready to schedule my baptism.NameThis field is for validation purposes and should be left unchanged.