Baptism Application

Baptism Candidates, Please Fill Out 1st Part of Form Completely

Baby Dedications, Please Fill Out 2nd Part of Form Completely

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The Great Commission Matthew 28:18-20 reads,

"Then Jesus came to them and said, 'All authority in heaven and on earth has been given to me. Therefore go and make disciples of all nations, baptizing them in the name of the Father and of the Son and of the Holy Spirit, and teaching them to obey everything I have commanded you. And surely I am with you always, to the end of the age.' "

Baptism Candidate's Information (18 & older):

LName FName

MName Age

Educational Level Phone

Email Address St Address

City State

Zip Code

How long have you been a member of Bethel Impact Church?

For the baptism, please wear white or dark t-shirts and pants clothing. Bring a change of dry clothing and a plastic bag for wet clothing . A church staff personnel will contact you with further details. Thank You!

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Baby/Child Dedication Information (17 & Younger)

Child's Information

LName FName

MName Age

Educational Level

Father's Information

LName FName

MName Age

Educational Level Phone

Email Address

Mother's Information

LName FName

MName Age

Educational Level Phone

Email Address Street Address

City State

Zip Code

For baby/child dedication, please dress child in appropriate dark or white attire. A church staff personnel will contact you with further details. Thank You!

Baptism Application

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