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Baptism Information
Zion Lutheran Church
203 S Vine St.
Mt. Pulaski, IL 62548
Please fill out the following information for your upcoming baptism! Please use full legal names, complete each blank, and double-check spelling so we can fill out the baptism certificate.
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Full Name of Child
*
Your answer
Sex of Child
*
Male
Female
Date of Baptism
*
MM
/
DD
/
YYYY
Date of Birth
*
MM
/
DD
/
YYYY
Location of Birth (Hospital)
*
Your answer
City and State of Hospital/Birth Place
*
Your answer
Mother's Full Name
*
Your answer
Father's Full Name
*
Your answer
Address
*
Your answer
E-mail Address
*
Your answer
Phone Number
*
Your answer
Sponsor's Full Name(s)
*
Your answer
Please tell us a little about your sponsors and why you chose them as examples of the faith for your child:
*
Your answer
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