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Baptism Request

Please print & use full names

Digital baptism request

Date of Application*

Date of Application

Candidate's Name*

Gender*

Date of Birth*

Date of Birth

Age*

Place of Birth*

Address*

City*

State*

Postal*

Father's Full Name*

Mother's Full Name*

Occupation*

E-mail*

Religious Affiliation of Parents*

Phone Number*

Work Number*

Name*

Age*

Name*

Age*

Name*

Age*

Name*

Address*

Name*

Address*

Requested Date of Baptism*

Requested Date of Baptism

Requested Time & Location*

Other Remarks