Water Baptism Form

Water Baptism
Do you attend online or in person? *

In Person Online
Full Name *

First Name Last Name
Gender *

Male Female
Birth Date *

Month Day Year
Marital Status *

Married Single Widowed Divorced
Address *

Street Address Apt. #
City, State *

City State / Province
Zip Code *
Mobile Phone *
E-mail *
example@example.com
Have you accepted Jesus Christ as your Personal Savior? *

Yes No
How long have you been attending LTF? *
Have you been baptized? *

Yes No
If yes, where?
Baptism Date

Month Day Year
Was Certificate Issued?

Yes No
Should be Empty: