Student Baptism Interest Survey
Please fill out this survey if you are interested in being baptized. Your responses will help us understand your journey and assist you in the baptism process.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Current School Grade or Year
*
Please Select
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
University/College Student
Other
Have you been baptized before?
*
No, I have not been baptized
Yes, as an infant
Yes, as a youth/teen
Other
Briefly share why you are interested in being baptized at this time.
*
Which church do you currently attend, if any?
Do you have a preferred time or date for baptism? (Optional)
Submit Survey
Should be Empty: