Request for Baptism

Congratulations on taking this important step—making a public declaration of what Jesus has done in your life! Please complete this form to help us schedule a date for your baptism. If the candidate is a minor, please provide the name and information of the parent or guardian in the top section, and the name of the baptismal candidate below.

Your name *

Email address *

Address *

Phone number

How would you like the name of baptismal candidate to appear on the baptismal certificate?

How would you like the name of the baptismal candidate to appear on the cover of their Bible?

Each person baptized at Spencerville Church receives a free copy of the Andrews Study Bible with their name engraved on the front cover. Sometimes, candidates prefer to have their name appear differently on their baptismal certificate than on their Bible. This is why we ask for both.

Is the baptismal candidate a minor?

Yes

Baptismal candidate's date of birth: *

Gender

Marital status

Ethnicity (optional)

Who will be the baptizing pastor? *

Please provide three options for your preferred date of baptism (in order of preference): *

While we can't always guarantee your first choice of dates, we always seek to honor requests as we can. If your requested dates are unavailable, we will follow up by phone to offer additional options.

Will membership be held at Spencerville Church? *

Yes

Questions, Comments, or Requests?

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