Baptism Request Form (Adult)

First Name*
Middle Name*
Last Name*
Birthdate*
Contact Number*
Email Address
Have you been baptized previously?*
If yes, approximate date of previous baptism
Have you prayed the prayer of Salvation and confessed Jesus as Lord and Savior over your life (are you Saved)?*
Approximate Conversion Date (your Salvation date)
What is the meaning/purpose of baptism?*
Why do you desire to be baptized?*


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