Baptism Request

Please provide the following information. An Anchor staff member will follow up with you once it is submitted. If you have questions, please contact the Anchor office.

Name

First Name

Last Name

Phone

(###)

###

####

Email Address

Parent Name (if a child under 18)

First Name

Last Name

Age of person being baptized (if under 18)

Name of the person you would like to baptize you?

Personal testimony