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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.


Title:
First Name:
Surname:
Date of Birth:   Age:
Gender:
Marital Status:
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?
* Do you attend CityLife Church?
* Where do you regularly attend CityLife Church?               
* Are you a member of a LifeGroup?

In your own words, please state why you desire to be baptised by immersion: