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Application for Water Baptism
Please complete the following information, which will be used to enable us to process your baptism application and issue a certificate.
Please tick here if you are a parent registering your child for water baptism.
Title:
Mr
Mrs
Ms
Miss
First Name:
Surname:
Date of Birth:
Age:
Gender:
Male
Female
Marital Status:
Single
Married
Other (please specify):
Postal Address:
City/Suburb:
Postcode:
Day-time Contact Number:
Other Contact Number:
Email Address:
Please answer the following:
How long have you been a Christian (ie, having accepted
Jesus Christ as your Saviour)?
years
months
Have you ever been baptised by immersion before?
Yes
No
In which church?
Do you attend CityLife Church?
Yes
No
Where do you regularly attend CityLife Church?
Knox
Casey
Manningham
Hobsons Bay
Chinese
Spanish
Are you a member of a Life Group?
Yes
No
Life Group Leader's Name:
In your own words, please state why you desire to be baptised by immersion:
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