Baptism Request Form

Please fill out the following form to submit a Baptism request.
Email Address
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Name of Child
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Type of Baptism Requested
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Sex
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Date of Birth

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Place of Birth(*)
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Name of Mother(*)
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Is she a member of Greater Centennial Church?(*)
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Name of Father(*)
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Is he a member of Greater Centennial Church?
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Address(*)
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Address line 2(*)
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City, State, Zip(*)
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Phone Number
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Name of Godparent 1(*)
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Name of Godparent 2(*)
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