Baptismal Certificate 
 
 
 
This certifies that 
 
 
________________________________________________ 
 
 
after having professed a repentance toward God 
and a saving faith in Jesus Christ, 
was baptized in the name of the Father, 
the Son, and the Holy spirit, 
 
at ______________________________
 
 
near ____________________________ 
 
 
on the ____ day of ________________ 
in the Year of Our Lord ______ 
 
 
Baptism performed by _________________________ 
 
 
Witnesses 
____________________________
 
____________________________ 
____________________________ 
____________________________ 
 
 
EmbassyOfHeaven.org 
Send to Embassy of Heaven Church; PO Box 337; Stayton, Oregon 97383-0337 for recording.