Baptism Application

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Childs full Name :*
Childs Date of Birth:*
Mother Full name :*
Mothers Occupation:*
Fathers full name :*
Fathers Occupation:*
Postal address (inc postcode ):*
Phone Number (inc area code):
email address:
Why do you want your child baptised?:*
Why do you want baptism in the benefice?:*
church affiliation:*
Church of England
No church affliliation
Baptist
Methodist
Catholic
Free Church
Marital Status :*
Married
Divorced
Single
Cohabiting
Other
By ticking this box we confirm we will undergo such baptism preparation as is required.:*
Yes
Please enter the verification number on the right:*
one two one one one
* Required Fields