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