Baptism Request Form

Your name *

Last name

Email address *

Phone number *

Phone type

MobileHomeWorkOther

Address *

HomeWorkOther

Country

Country

Street Address

Apt/unit/box (optional)

City

State

Postal code

Birthdate *

Gender *

Select…MaleFemale

When did you start attending New Life Church? *

Year

What is your occupation?

What is your t-shirt size? *

Select…XSSMLXLXXL

Submit

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