Baby Dedication Requests – NEW JERUSALEM WORSHIP CENTER

This form is to request a baby’s dedication to the Lord. Baby dedications are conducted on the 2nd Sunday of each month, except for the month of October and November where it will be conducted on the 3rd Sunday. Dedications must be scheduled a minimum of 6 weeks prior to the requested date.

Requestor Name(Required)

Email(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Requested Dedication Date(Required)

Full Name of Baby(Required)

Baby's Date Of Birth(Required)

What is the Baby's City and State of Birth?(Required)

Mother's Full Name(Required)

Is mother a member of New Jerusalem?

Yes

Father's Full Name(Required)

Is father a member of New Jerusalem?

Yes

Godmother's Full Name

Godfather's Full Name

Phone

RESOURCES

Contact Info

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