FIRST UNITED CHURCH - BAPTISM RECORD

Full Legal Name of Child to be baptized:

Gender:

Date of Birth:

Place of Birth:

FATHER’S INFORMATION:

Full Legal Name:

Occupation: Religion:

Age: Birth Place:

Church Status: Baptized Yes No; Confirmed Yes No; Attends Worship Yes No

MOTHER’S INFORMATION:

Full Legal Name:

Occupation: Religion:

Age: Birth Place:

Church Status: Baptized Yes No; Confirmed Yes No; Attends Worship Yes No

NAMES & BIRTH DATES OF OTHER CHILDREN:

Sponsor:

Marital Status of Couple:

Address:

Telephone:

Date of Baptism:

Date of interviews with Minister:

Date Entered in Register:

Date Returns forwarded to Vital Statistics:

Notes: