805 Mt. Vernon Hwy NW

Atlanta, GA  30327

404-255-4023

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Baptismal Information
Please give us Baptism candidate's name and additional information to request a date for Baptism.
Baptismal Information
* Required
First Name *
Middle Name *
Last Name *
 
Email Address (For example: name@company.com)
 
Birthday *
 
Address Line 1 *
Address Line 2
City *
State *
Zip Code *
 
  Area Code Phone Number  
Home Phone
  
Mobile Phone
  
 
Requested Date for Baptism (mm/dd/yyyy)
 
Gender *
Male
Female
 
City and State of Birth *
 
Father's Full Name
 
Mother's Full Name
 
Church Member
Yes
No
 
Godparent or Sponsor (full name) #1
 
Godparent or Sponsor (full name) #2
 
Godparent or Sponsor (full name) #3
 
Godparent or Sponsor (full name) #4
 
 
Please complete this form and submit to request a date for baptism.
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