AV. Los Jazmines, Calle 6, Edif.

#5 Next to Play
Santiago, RD. - 829- 341-9245

Water Baptism Request Form.

Date____/_____/_____

Please complete these blank spaces to obtain your registration details. Responses will be kept confidential. The
objective is to know you better and provide you with spiritual follow-up as God intended.

PERSONAL INFORMATION.

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Names and surnames:
____/______/_____ ______________________________________ _________ ________________
Date of Birth: Nationality: Age: Telephone (home)

___________________________________________________________ ______________________
Address: Cell:
____________________________________ _______________________________________________
Email: (E-Mail) Facebook:

____________________ _________________________________________ _____________________

Marital Status: Name of Spouse: Married Time:
__________ ________ ________________________________________________________________
He has children? How many? Children's name:

_______________________________ __________________________ _________________________

Studies Completed: Profession: Occupation:

_______________________________________ Sex M F
Date you accept Jesus as your Savior:
________________________________________________________ ____________________________
How long do you have to attend Church? Date set for Baptism

______________________________________________________________________________________
Briefly say why you want to be Baptized
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For this form to be complete, please complete the questionnaire located behind it. Your answers must be
sincere. If you don't understand a question, don't be afraid to ask. Thank you.

___________________________________ __________________________________
Signature of the applicant Pastoral Signature
 QUESTIONNAIRE FOR APPLICATION FOR WATER BAPTISM

1. Did you receive the Baptismal course for new believers? But

2. Does your family agree that you be baptized? But

3. Did you receive the baptism in the Holy Spirit? But

4. Do you attend all services? Regularly Occasionally I do not attend

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5. Explain the reasons why you are not attending.

6. Do you attend worship on Sunday? But

7. How much time do you dedicate to prayer? Daily Never Sometimes

8. Do you practice fasting? Frequently Occasionally Never

9. Do you currently tithe? But

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10.What are the reasons why you do not tithe?

11.Do you agree with what God teaches regarding Tithing? But

12.Do you collaborate in the work of God? Cleaning Visiting Evangelizing

13.Do you have dating relationships? But

14.Is your boyfriend/girlfriend a believer like you? But

15.Is your pastor aware of your engagement? But

16.Are you willing to keep the doctrine of this Church? But

17.Are you willing to respect the regulations that exist in this Church? But

18.If your application is not accepted, are you willing to wait? But

THANK YOU.