Personal Information

Name:

Phone:

Email:

Place Of Birth:

Baptism Information

I have completed the Baptism Bible Study:

Yes    No

I have written "My Story with God":

(Story should be completed on 1-2 separate sheets.)

Yes    No

You may be asked to be baptized in the service you did not choose depending on the number of baptisms scheduled for that day.

In which service would you like to be baptized?:
9:15 AM 11:00 AM

Connection Information

Are you connected to a Southridge Life Team or Support Group?:

Yes    No

My Team Leader is:

Do you serve on a Southridge ministry team?:

Yes    No

The team I serve on is: