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Baptismal Request Form

If you have never visited New Life, we encourage you to visit for worship service and meet Pastor Rakel. If you wish to be baptized or have a child baptized, please complete this request form.

Baptism Information

Name of Person to be Baptized:*
First Middle Last
Preferred Baptismal Date:*
MM slash DD slash YYYY
Time of Service*
- 8:15 am
- 10:15 am
- Other
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Phone Number*
Birthdate*
Birth Place:*
City and State
PARENT 1 Name:*
First Middle Last
SURNAME at Birth:
Last
Member at New Life:
- Yes
- No
PARENT 2 Name:*
First Middle Last
SURNAME at Birth:
Last
Member at New Life:
- Yes
- No
Sponsors Names:
Please list the first and last name of each sponsor.
Anticipated Number of Guests:
Hidden
Name of Officiate:
First Last
Hidden
Name of Congregational Sponsor:
First Last