Trinity - Clifton Pastoral Charge
Baptismal information sheet

Requested Date of Baptism: ______________________________________________________

Place of Baptism: Clifton___________________     Trinity __________________________

Name of person being baptized: ___________________________________________________

Date of Birth: __________________________________________________________________

Place of Birth: _________________________________________________________________

Parent #1’s Full Name: __________________________________________________________

Parent #2’s Full Name: __________________________________________________________

Mailing Address: _______________________________________________________________

Telephone number: Day ________________________	Night ________________________

I/we are members of: (where each of you were baptized and confirmed)
Parent #1: _______________________________________________________________

Parent #2: _______________________________________________________________

Please Complete the following:

I/we would like our child to be baptized because: ________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

-1-

When my/our child is twenty- one years old I/we will have done the following to raise him/her within the Christian Community: ____________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

I/we will want to teach our child the following things about what it means to be a follower of Jesus Christ: _________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Signed:	 _____________________________
 _____________________________

-2-

_