Child Dedication Application

Child Dedication Application
Date of Application

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Hour MinutesAM/PM Option
Requested Date of Dedication (Saturdays ONLY)

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
What is the number of all attendees (Including Parents & siblings)?
MAXIMUM OF 20 ATTENDEES
Contact Person
Contact Name

First NameLast Name
Contact Phone
Please enter a valid phone number.Format: (000) 000-0000.
Contact Email
example@example.com
- Child's Info
- Name of Child
  
  First NameMiddle NameLast NameSuffix
- Date of Birth
  
  MonthDayYear
- Place of Birth (City, State, Country)
- Enter Initials That Child's Information Is Correct
- Father's Info
- Father's Name
  
  First NameMiddle NameLast Name
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Primary Number
  Format: (000) 000-0000.
- Mobile Number
  Format: (000) 000-0000.
- Work Number
  Format: (000) 000-0000.
- E-mail
  example@example.com
- Mother's Info
- Mother's Name
  
  First NameMiddle NameLast Name
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Primary Number
  Format: (000) 000-0000.
- Mobile Number
  Format: (000) 000-0000.
- Work Number
  Format: (000) 000-0000.
- E-mail
  example@example.com
- A Meeting With An Elder Is Required PRIOR To The Dedication:
- Parent's Signature
- Office Use Only
- Event Approved
  
  Other
- Dedication Approved by Pastor?
- Has Date Been Approved by an Elder?
- Name of Elder Performing Dedication?
- Meeting With Elder Date
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
- Departments Notified of Dedication:
  
  Other
- Event Completed
  
  Other
- Should be Empty:

Child Dedication Application

Contact Person

Child's Info

Father's Info

Mother's Info

Office Use Only