Please complete the following information.  

Provide the names as you would like them to be appear on the child's dedication certificate.  Only one parent name is required, but include both if you wish them both to be on the certificate.

For additional questions, please contact the church office at 352-376-6320 M-Th 9:00 a.m. - 4:30 p.m. or e-mail theresa@thepentecostalsgnv.com