Greater Centennial A.M.E. Zion Church

BAPTISM REQUEST

Name of Person Being Baptized	*
Type of Baptism Requested	*
Sex	*
Date of Birth - Month/Date/Year	*
Place of Birth	*
Address	*
Unit/Apt #
City, State, Zip	*
Contact Number	*
REQUIRED INFORMATION FOR CHILDREN UNDER 18 YEARS OF AGE
Name of Child's Mother/Guardian
Is she a member of Greater Centennial A.M.E. Zion Church
Name of Child's Father/Guardian
Is he a member of Greater Centennial A.M.E. Zion Church
Name of Godparent (s)
Your Email Address	*