Baptism Request

Our Location

JENELIM Center, Membley – Ruiru, off Bypass, Kenya

Phone Number

Email Address

JENELIM Baptism Request Form

Buried with Him in baptism, wherein also ye are risen with Him through the faith of the operation of God, who hath raised Him from the dead. – Colossians 2:12

Full Name*
First Middle Last
Sex*
Date of Birth*
DD slash MM slash YYYY
Address*
Street Address State / Province / Region Country
Phone No.:*
Email*
Please check the ones that apply:*
- I’m a member of JENELIM and I want to be baptized
- I’m a member of JENELIM and I want to have my child baptized (Fill out the information below please.)
- I’m not a member of JENELIM but I want to be baptized – If you’re a member at another church, what is the name of your church?
Your Church
Information of Parents if your Child is being Baptized
Father’s Full Name
First Middle Last
Mother’s Full Name
First Middle Last
Date of Marriage
MM slash DD slash YYYY
Child’s Full Name
First Middle Last
Child’s Date of Birth
MM slash DD slash YYYY
Information of Godparents
Godfather’s Name
First Middle Last
Godmother’s Name
First Middle Last
Signature:
If under 18 years of age, Signature of Parent:
Office Use Only
Date of Baptism Approval:
Elder Assisting:
Copies To:
- Requested Pastor
- Officiating Clergy

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Baptism Request

Our Location

Phone Number

Email Address

JENELIM Baptism Request Form

Information of Parents if your Child is being Baptized

Information of Godparents

Office Use Only

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