Fill this form out to tell us about yourself. Someone will contact you with dates and information.

Name

First Name

Last Name

Phone

(###)

###

####

Where do you want to be baptized?

Sunday Church Service

Beach

Do you believe you have a relationship with God?

In light of the above questions, on what do you base your belief?

Please explain how and when you placed your faith in Jesus Christ as your Savior?

Why do you want to get baptized?

Please list any ministry areas which led you into beginning a relationship with Jesus and/or have helped you to grow in your relationship with Jesus.