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
Format: (000) 000-0000.
Parent/Guardian Information

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

First NameLast Name
Phone Number
Format: (000) 000-0000.
Alt. Phone Number
Format: (000) 000-0000.
Have you received Jesus Christ as your personal Savior? (Are you saved?)
How long have you been attending Highland Church?
Would you like to attend Foundations of Faith? (A class for new believers)?
Additional Comments
Please upload a current profile photo of yourself

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Should be Empty: