CITYHEART BAPTISM
Baptism Candidate Info
Is this for a child 1st grade - 17 years old?
*
Yes
No
First Name
*
Gender
Male
Female
Marital Status
Single
Engaged
Married
Partner
Widowed
Divorced
Separated
Have you accepted Jesus as Your Lord and Savior?
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Yes
No
Salvation Date
Last Name
*
Date of Birth
*
School Grade
*
-- None --
Nursery (Babies 0-11mths)
1s (12-23mths)
Toddler (2+3s)
Preschool (4+5yrs)
Kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
Parent's First Name
*
Parent's Last Name
*
Let us know the best way to connect.
Email Address
*
Mobile Number
*
I'm Making the Decision to...
This is one of the most important things you can do for your faith!
Get baptized
Choose Event
Baptism
(824 S State St, Jackson MS 39201)
Dec 15, 2024 10:00 AM
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