ITEM BLANK FOR BAPTISM, CHILD BLESSING, PRIESTHOOD

 

                 THE CHURCH OF CHRIST

                            "The Church with the Elijah Message"

               Headquarters:  Independence, Missouri, U.S.A.

 

Full Name:  _______________________________________________________________________

Date of Birth (Month)  ___________, (Day) ____, (Year) _________ at (City) ____________________

(County) __________________, (State/Province) _______________, (Country) __________________

Father:  ______________________________  Mother:  _____________________________________ 

 

___  Baptism

        Date Baptized (Month):  ______________________  (Day) _________    (Year) _____________

        Location of Baptism:  ____________________________________________________________

        Baptized by (Name):  ____________________________________________________________

        Confirmed by:   _________________________________________________________________

        Assisted by:  ___________________________________________________________________

 

___  Child Blessing

        Date Blessed (Month):  ______________________  (Day) _________    (Year) _____________     

        Location of Blessing:  ___________________________________________________________

        Blessed by (Name):  ____________________________________________________________

        Assisted by:  __________________________________________________________________

 

___  Priesthood   

        Ordained to the office(s) of:  ______________________________________________________

        Date Ordained (Month):   ______________________  (Day) _________    (Year) _____________     

        Location of Ordination:  __________________________________________________________

        Ordained by (Name):  ___________________________________________________________

        Assisted by:  __________________________________________________________________

 

Please send Certificate to:                                         Local Recorder (Name and Address):                      

___________________________________              ___________________________________

___________________________________              ___________________________________

___________________________________              ___________________________________

 

                                                                 _________________________________________________

                                                                 Signature of Officiating Elder                                       Date