Spiritual Vitality Check

Thank you for taking the time to complete this Spiritual Vitality Check. It should only take 5 minutes to complete but it will give the staff at Bethel a good amount of information for us to use when developing programming.

Please download and return the form to

Bethel Lutheran Church
c/o Spiritual Vitality Check
312 Wisconsin Ave
Madison, WI 53714

Take the Spiritual Vitality Check

Name
This field is for validation purposes and should be left unchanged.
Baptismal Candidate Full Name*
Gender*
Has the child been born yet?
- Yes
- No
Date of Birth:
MM slash DD slash YYYY
City of Birth*
Parent 1 Name*
Parent 2 Name*
Street Address*
City, State, Zip*
Phone Number for Parent 1*
Phone Number for Parent 2*
Email Address for Parent 1*
Email Address for Parent 2*
Sponsor(s) Name(s)*
First Choice for Baptism Date*
MM slash DD slash YYYY

Baptisms are performed on the 2nd, 4th, and 5th weeks of the month during our regular worship times.
Time of Service Preferred*
Second Choice for Baptism Date
MM slash DD slash YYYY

Baptisms are performed on the 2nd, 4th, and 5th weeks of the month during our regular worship times.
Time of Service Preferred
Does Parent 1 have a church membership?*
- Yes
- No
Does Parent 2 have a church membership?*
- Yes
- No
If no, then I am a member of...*

A congregation of the
Evangelical Lutheran
Church in America

Bethel Lutheran Church

312 Wisconsin Avenue
Madison, WI 53703-2108

(608) 257-3577

(608) 257-4044 - FAX

Bethel Horizons

South-Central Synod Wisconsin

Bethel is a Reconciling in Christ congregation