Baptism Application
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First Name *
Last Name *
Facebook
Email *
Phone *
I am a born again Christian *
How long have you been a Christian?
How long have you been with Channel Church?
I want to be baptized because *
I have received baptism *
Date of baptism
MM
/
DD
/
YYYY
Officiating church
Former church membership
Channel Church | channelchurch.org | info@channelchurch.org | 510.224.5546
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