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 State ZIP Code
Birth Date
MM slash DD slash YYYY
Home Phone
Cell Phone
Email*
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.
Phone
This field is for validation purposes and should be left unchanged.

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