Request for Baptism

Baptism Request Form

Baptism Date Requested *

Please choose *

Infant/child baptism Youth baptism (6th grade or older) Adult baptism

Membership at FPC *

One parent is a member Both parents are members

Full name of person being baptized *

Goes by *

First Name

Date of birth *

Month Day Year

Gender *

Place of birth *

City, State

Baptize additional child? *

Full name of child *

Goes by *

First Name

Date of birth *

Month Day Year

Gender *

Place of birth *

City, State

Parents' full names *

Names parents go by *

Address *

Street Address

Street Address Line 2

City State

Zip Code Country

Phone Number *

Email *

example@example.com

A list of current Elders can be found here.

Name of Elder (if unsure, type TBD) *

Baptism requires an active or inactive Elder from FPC to assist at the service.

Name of Guest Elder

A family member or friend who is or has served as an Elder in the Presbyterian Church USA may also participate in service as a Guest Elder (this is in addition to an FPC Elder).

Guest Elder's email address *

example@example.com

Number of reserved pews needed *