Water Baptism Class Registration Form

Water Baptism Application
Applicant's Name*

First NameLast NameSuffix
Birth Date*

MonthDayYear
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
example@example.com
Phone Number*
Parent/Guardian Information

(If under 18 years of age)
Relationship to the Applicant
Name

First NameLast Name
Phone Number
Alt. Phone Number
Have you received Jesus Christ as your personal Savior? (Are you saved?)*

YESNO
How long have you been attending Highland Church? *
Would you like to attend Foundations of Faith? (A class for new believers)?*

YESNO
Additional Comments
Please upload a current profile photo of yourself*

Cancelof
Should be Empty:

Water Baptism Application