Request for Baptism

If you would like to make a request for baptism, please fill out the form below. An elder or minister will contact you shortly. Alternatively, download this form, fill it out and mail it to:

Baptism Request
Highfield Road Uniting Church
52 Highfield Road
Canterbury 3126

Child's Full Name:
Date and Place of Birth:
Father's Name:
Have you been baptised?	Yes No
Have you been confirmed?	Yes No
Mother's Maiden Name:
Have you been baptised?	Yes No
Have you been confirmed?	Yes No
Home Address:
Telephone:
Names of other children, and when and where baptised:

Suggested date of baptism: