Baptism Request

1. Email: *

This address will receive a confirmation email

2. Date desired mm/dd/yy for baptism: * (office will confirm if date is available)

3. First, Middle, and Last Name of person getting baptized*

4.Member(s) of Shalom Lutheran: *

5. Birthday of person getting baptized mm/dd/yy: *

6. Baptismal person birth place: (city, state, and hospital)

7. Gender: *

8. Parent (1) Name (First, Last):

9. Parent (1)Address:

10. Parent's (1) cell phone number: (internal use only)

11. Parent's (2) Full Name:

12. Parent (2) Address:

13. Parent's (2) cell phone number: (internal use only)

Sponsor/Godparent(s) Name: * (if married, list together)

Description

Thank you for taking this step to help plant the seeds of faith and nourish spiritual growth.