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 Sunday
(824 S. State Street, Jackson, MS 39201)
Aug 18, 2024 12:00 AM
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Submit