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Baptism Information Sheet

Upon receipt of the baptism request, the information is brought to the next staff meeting for review of the date with the worship calendar. The Senior Pastor will call and set up an appointment for the parent(s) to come and talk about the baptism. Occasionally, you may receive a return email or phone call from Terri Johnson, Administrative Coordinator, inquiring about a different date for the baptism.

Full name of individual to be baptized (first, middle, last):
Baptism For :
  
Preparation Member?
 yes no
Date of Birth:
Place of Birth:
  
Requested Date for Baptism:
    
To be baptized here?
 yes no        where?
Parent(s) Name(s):
  
Address (street, city, state, zip+4):
Phone:
  
Email Address:
  
Is a parent(s) a member of Chicago Temple? If so, list name:
  
Mother's Maiden Name:
  
Sponsor's Names:
  
Sponsor's Addresses and Phone: