Water Baptism Form
Water Baptism Form
Please complete the following information, which will be used to enable us to process your baptism application and issue a certificate.
Last Name  * 
First Name  * 
Date of Birth  * 
Phone Number.
Gender  * 
Marital Status  * 
Street Address  * 
City  * 
State  * 
Zip  * 
Have you been born again? (ie, having accepted Jesus Christ as your Saviour)?  * 
Have you ever been baptized by immersion before?  * 
Do you attend Bethel Family Worship Center?  * 
In your own words, please state why you desire to be baptized by immersion:
Your Email Address  * 
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