DETAILS OF CHILD BEING DEDICATED:
FIRST NAME:
*
D.O.B:
*
HOME ADDRESS:
*
HOME CITY:
*
LAST NAME:
*
GENDER:
*
Male
Female
HOME POSTCODE:
*
CAMPUS:
*
All Nations Church (Wolverhampton)
All Nations Church (Telford)
Grace Church (Dudley)
Bridge Church (Dudley)
All Nations Punjabi Church (Wolverhampton)
All Nations Chinese Church (Wolverhampton)
Online Church
PARENTS DETAILS:
Full name of father:
Email Address:
Full name of mother:
How long have you been married:
Father's Mobile Number:
Mailing Postcode:
Mother's mobile Number:
FURTHER DETAILS:
WHEN DID YOU JOIN ALL NATIONS:
THE ALL NATIONS CHURCH YOU ATTEND:
ALL NATIONS CHURCH
PUNJABI CHURCH
STRAITS CHURCH
HOPE CHURCH
GEM CHURCH
CHINESE CHURCH
GRACE CHURCH
STRAITS CHURCH
NAME OF LIFE GROUP LEADER:
Previous Church and Church Rev / Pastor details:
Name of Pastor:
Address of Church:
Church Postcode:
Date of this application:
Submit
