Water Baptism Online Application

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:
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 Chinese Spanish
Are you a member of a LifeGroup?	Yes No	LifeGroup Leader's Name:

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