Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Birthday
*
-
Month
-
Day
Year
Date
Marital Status
*
Please Select
Married
Single
Divorced
Widow/Widower
Are you currently attending a small group?
*
Please Select
Yes
No
To the best of your knowledge, when were you saved?
*
Have you been baptized before? If yes, when?
*
Why do you want to be baptized?
*
Is there anyone you would like to invite to the baptism to encourage you or testify to the fruit of your conversion?
*
In preparation for baptism, and as a means of glorifying God as you testify to His grace, please write out the story of your conversion. You may include significant people, experiences, or other influences in coming to know Jesus Christ. Aim for at between 1 and 2 full pages, double spaced. A pastor will review your testimony with you and help you fine tune it for sharing at your baptism.
*
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