Centennial Celebration Program Application

Centennial Celebration Program Application
Church Name:
Church Physical Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Date Organized:

MonthDayYear
Date
Current Pastor’s Name:

First NameLast Name
Contact Name:

First NameLast Name
Contact Email:
example@example.com
Contact Phone:
Please enter a valid phone number.
Mailing Address for Packet:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Historical Information
Provide a brief history of the church, including its founding, significant milestones, and impact in the community.
Where possible, please upload a photo of the current church building and any historical photos you would like featured in the White Wing Messenger magazine.

Cancelof
Verification
National/Regional/State Administrative Bishop’s Name:

First NameLast Name
Name of Church as it Should Appear on the Letter and Plaque:
Date Needed, if Conducting an Anniversary Event:

MonthDayYear
Date
Should be Empty:

Historical Information