Baptism Request Form (Child)

If there's more than one child,

please submit a baptism request for each child.

Parent's First Name (1)

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Parent's Last Name (1)

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Parent's First Name (2)

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Parent's Last Name (2)

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* Email

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* Phone number

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* Address

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* City

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* Country

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* State/Province

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* ZIP/Postal

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Current Church Membership

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* Child's First Name

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Middle Name

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* Child's Last Name

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* Child's Birth Date

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Place of Birth

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Godparent (Sponsor) Name (1)

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Relationship (1)

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Godparent's Email (1)

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Godparent (Sponsor) Name (2)

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Relationship (2)

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Godparent's Email (2)

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* Baptism Request Date 1st Choice

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* Baptism Request Date 2nd Choice

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Edison Park Lutheran Church | 6626 N Oliphant Ave | Chicago, IL 60631 US

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