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Mayfield Church Baptism Request Form 2025
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* Indicates required question
Email
*
Your email
Baptism date desired
MM
/
DD
/
YYYY
Service
9:30 am
11:00 am
Clear selection
Full Name of Candidate
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Place of Birth
*
Your answer
Age
Infant/child
Youth
Adult
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Gender
Male
Female
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Family Address
*
Your answer
Phone
*
Your answer
****Complete the following if the Candidate is an Infant or Child
****
Your answer
Father's Full Name
*
Your answer
Mother's Full Name
Your answer
Mother's Maiden Name
Your answer
Are you a member of Mayfield United Methodist Church?
Father - Yes
Father - No
Mother - Yes
Mother - No
If not a member, Faith Background?
Your answer
Maternal Grandparents
Your answer
Paternal Grandparents
Your answer
Will Grandparents be in Attendance?
Yes
No
Clear selection
Name of Siblings
Your answer
Will Siblings be in Attendance?
Yes
No
Clear selection
Godparents (If applicable)
Your answer
Will Godparents be in Attendance?
Yes
No
Clear selection
Will Other Family Members and/or Friends be in Attendance?
Yes
No
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Names & Relationships
Your answer
Other information you would like to share or questions you would like to ask?
Your answer
A copy of your responses will be emailed to the address you provided.
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