Baptismal Form
Gloria Dei Lutheran Church Information for Baptism (Please print names as they should appear on the certificate)
Email address *
Date of Baptism: *
MM
/
DD
/
YYYY
Service Time: *
Full name of the person to be baptized: *
Your answer
Date of Birth: *
MM
/
DD
/
YYYY
Place of Birth: *
Your answer
Name of Father: *
Your answer
Name of Mother: *
Your answer
Church membership status: *
Street Address: *
Your answer
City, State, Zipcode *
Your answer
Phone Number: *
Your answer
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