Immersion Form — Hilliard Church of Christ

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Email

Date of Birth

When did you start attending HCC?

What led you to the decision to want to get baptized?

Your Faith Story

How did you learn about baptism?

Please Select One

Whom would you like to baptize you?

When would you like to be baptized?

I agree with HCC's statement of beliefs

I agree