Baptism Personal Information

Please provide the following information by the WEDNESDAY BEFORE
you are baptized to be shared during your baptism.
To submit your personal information, fill in the form below
and then click the Submit Form button.

First Name: Last Name:
Email Address:

Name to be used on Baptism Certificate (if different from above):

Your personal testimony
(please see "What is a Testimony" for instructions on how to write your testimony):


What is your favorite Bible verse?

Who would you prefer to baptize you? (check one):
Jim Barringer Chris Gee Conrad Anderson

If you have questions, please contact Jim Barringer at 952-567-6464 or