BAPTISM REQUEST FORM
Next Baptism: June 24, 2012 10:45am
Please complete the following request for baptism. After the information is reviewed, we will confirm your baptism date via email or mail and provide further information for the day of baptism. Please contact our office if you have any questions or need further information.
Name
Email
Address
City State Zip
Phone Alt Phone
This is baptism is for:
Select OneAdultChild Under 8Child Over 8
Please indicate full name of person to be baptized, including middle name (needed for baptism certificate). If there is no middle name, please leave that blank empty.
First Middle Last
Birth date (required)
Parent(s) Name(s) (for child baptism only)
Pictures of children (for slideshow during the baptism service)
Please e-mail a or bring it to the church office to be scanned by our graphic designer - your originals will be returned to you. Photo information is as follows: No blurry pictures or pictures with obstructions in front of the face. The background is always replaced with a backdrop that looks like water, due to the water backdrop, color photos are preferable.
Indicate the baptism date you are requesting:
Baptism Service Time is: 10:45 am service.
When did you become a member of SRC? (actual or approximate date)
Note: The term "member" means you have attended the Newcomers membership class (or Communicants as a youth) and have been interviewed by an elder and accepted into membership at SRC.
What areas of ministry are you or your family connected with at SRC? (answer not required)
You may also provide a brief comment about your family that you would like the pastor to know at this time -information may or may not be used during the baptism. (answer not required)
A confirmation of your request and further information will be provided after your request is processed and will contain instructions for the day of baptism and confirmation of the day and time.
Enter the numbers as they are shown in the image above
