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Baptismal Information Form
Bethany Lutheran Church - Parkway Campus: 530 W. Parkway Blvd. Appleton, WI 54911
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* Indicates required question
Name of Child (First, Middle, and Last)
*
Your answer
Gender of Child
*
Female
Male
Child's Date of Birth
*
MM
/
DD
/
YYYY
Birthplace (Hospital, City, State)
Your answer
Baptism Date
*
MM
/
DD
/
YYYY
Place of Baptism (Church, City, State)
Your answer
Baptism Officiating Minister
Your answer
Godparents/Sponsors/Witnesses
Your answer
Name of Father (First, Middle, and Last)
Your answer
Name of Mother (First, Middle, and Last)
Your answer
Address (include City, State, & Zip Code)
Your answer
Primary Phone Number of Dad
Your answer
Dad's Email Address
Your answer
Primary Phone Number of Mom
Your answer
Mom's Email Address
Your answer
Special Instructions
Your answer
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