Adult Baptism Request Form

Adult Baptism Request Form

* Indicates required field

Requested Baptism Date *

Requested Service Time *

10:00 am service

First Name *

Middle Name *

Last Name *

Birth Date *

Home Phone Number *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Member of NSUMC? *

Yes No

Godparent if applicable *

First

Last

Godparent if applicable *

First

Last

Additional Information *

Submit

Please allow 48 hours for a response