Baptism Request Form

Name of Person Being Baptized	*
Date of Birth	*
Parents' Names	*
Siblings' Names
Godparents' Names
Grandparents' Names
Hospital of Birth	*
Primary Contact Name	*
Primary Contact Email	*
Primary Contact Phone #	*
Primary Contact Address	*
Requested Month of Baptism Ceremony	*
Preferred Worship Time	*	9:30 Worship 11:00 Worship
Preferred Method of Baptism	*	Immersion (available at 9:30 only) Sprinkle
I understand that I will be contacted by a pastor about the details of my request upon submission. I understand that my request is not confirmed until I receive notification from a PWUMC staff person/pastor.
I have read and understand the above statement.	*	Yes