Baptismal Application - Bethany Lutheran Church • Bethany Lutheran Church

Email Address *

Preferred Date of Baptism *

Second Choice for Date of Baptism *

Bethany gathers for one Sunday worship service at 9:30 AM. Baptisms scheduled during this period would be celebrated during the 9:30 AM service.

Please fill out the following with the information of the person being baptized.

First Name of Person Being Baptized *

Middle Name

Last Name *

Parents' Names (if candidate is a child)

Siblings

Home Address *

Home Address Line 2

Home City *

Home Zip Code *

Home State *

Phone Number *