Heartland Baptism Request Form

Your name *

Email address *

Phone Number *

BAPTISM CANDIDATE INFORMATION:

Name of Baptism Candidate: *

Baptism Candidate's Date of Birth *

Which service would you want to be baptized? *

Please indicate your shirt size: *

Have you taken Heartland's Membership Class? *

In 3-4 sentences, how does a person begin a relationship with Jesus? *

Have you already been baptized since you began your personal relationship with Jesus Christ? *

Is your lifestyle reflective of your life in Christ? *

Please indicate which Pastor you would like to baptize you: *

Do you have any other questions or thoughts?

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