“Then Peter said to them, Repent and let every one of you be baptized in the name of Jesus Christ for the remission of sins, and you shall receive the gift of the Holy Spirit.”  Acts 2:38

By following this command, you are identifying yourself with the death, burial and resurrection of the Lord Jesus Christ.

If you desire to be baptized, please complete and submit the application below.

First Name

 

Last Name

 

Contact Number

Contact Number :: Ex. 1234567890

 

Date of Birth

Date of Birth :: Ex. mm/dd/yyy

 

Email

 

Date of Salvaton (estimate if not known)

Date of Salvaton (estimate if not known) :: Ex. mm/dd/yyyy

 

NOTE: If under the age of 17, a parent or legal guardian must sign and submit this request.

 

By checking here, you acknowledge that the below electronic signature is the person completing and submitting this application.

 

Electronic Signature (Enter your initials)

Electronic Signature (Enter your initials) :: Ex. ABC

 

Enter Code