Infant/Child Baptism Request Form

Infant/Child Baptism Form
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Member
Parent(s) Name(s)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Number

Area CodePhone Number
Email
example@example.com
Child's Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
God Parents' Name(s)
Other Information
(i.e.grandparents, etc)
Number of Attendees:
Date requested for Baptism Service*

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Upon completion of this form, you will be contacted with the date of the baptism service. If there are any questions, you may contact Rev. Dr. Garland D. Higgins at 404-827-9707 ext.105
- Date scheduled for the baptism service
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
- Requestor Contacted
  
  Other
- Date
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
- Should be Empty: