Baptism

Today's Date*

First, Middle & Last Name as it will appear on certificate.*

Gender*

Male
Female

Birth Date*

Birthplace: (City & State Hospital etc. was located)*

Baptism Date:

Service Baptism will be performed

Saturday-5:30pm
Saturday-After 5:30pm service
2nd Sunday-9am
4th Sunday-9am
2nd Sunday-10:30am
4th Sunday-10:30am
Sunday-After 10:30am service

Child's Ethnic Origin (select only 1, for ELCA Annual Report due mid-February every year)*

African American/Black
African National/African-Caribbean
American Indian/Alaska Native
Arab/Middle Eastern
Asian/Pacific Islander
Latino/Hispanic
Mult-ethnic
White/Caucasian
Other

Mother's First, Middle & Last Name*

Mother's Maiden Name [nee]*

Home Phone

Work Phone

Cell Phone*

Mother's Email*

Member or Non-Member*

Member
Non-Member

Father's First, Middle & Last Name*

Home Phone

Work Phone

Cell Phone*

Father's Email

Member or Non-Member*

Member
Non-Member

Address*

Street Address City ZIP Code

Godparent Name

First Last

Godparent Name

First Last

Godparent Name

First Last

Godparent Name

First Last

Date Beginning Families of Faith Taken*

MM

DD

YYYY

Both Parents Attended*

Yes
No

Is this your first child baptized here at Nativity?*

Yes
No

Baptisms at Nativity

Baptisms take place at all worship hours.

Pre-Baptism Information

About Nativity

Gather at Nativity

Community

Baptism

Baptisms at Nativity

Baptisms take place at all worship hours.

Pre-Baptism Information

About Nativity

Gather at Nativity

Community

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