Name* First Last Phone*Email* Do you affirm that you are a sinner in need of a savior, that you have confessed your sin to God, that you have asked for His forgiveness, and that by faith you are committed to following Him in obedience for the rest of your life?*YesNoHow long have you been a believer?*Example: I've been a Christ follower for fifteen years.What were the circumstances surrounding your salvation moment? (1-3 sentences)*i.e- prayed with my parents in my bed, at summer camp after my counselor talked with me, in my stakeholder meeting, etc.Have you ever been baptized before? If so when, what were the circumstances surrounding that event, and why do you feel the need to be baptized again?*What is your motivation for being baptized now?*Who would you like to baptize you?*Family or friends (indicate below)One of the pastors (indicate below)No preferenceIf you chose family, friend, or pastor to baptize you please indicate whom:
