Baptism Information Form:

Date Requested for Baptism: *
Person Baptized's Full Name: *
Person Baptized Goes By: *
Date of Birth: *
City/ State of Birth: *
Mother's Full Name: *
Mother Goes By: *
Father's Full Name: *
Father Goes By: *
Home Phone: *
Cell Number: *
Work Number: *
Address: *
Grandparents Members of FUMC, Lyons?: *
 Yes
 No
If Yes, Please Give Names: *
Number of Pews Needed: *
How many family members will attend: *
Please type the letters and numbers shown in the image.
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