Baby Dedication Form

Community Baptist Church of Englewood

224 First Street

Englewood, NJ 07631

Phone: 201-568-6369 Fax: 201-568-3512 www.cbcofe.org

Reverend Dr. Lester W. Taylor, Jr., Senior Pastor

CBC BABY DEDICATION FORM

Baby's Name: *

First Name Last Name

Baby's Date of Birth: *

- Month - Day Year

Hospital of Birth: *

Hospital City/State:

Mother's Name: *

First Name Last Name

Address: *

Phone Number: *

- Area Code Phone Number

E-mail:

Father's Name: *

First Name Last Name

Father's Address: *

Phone Number: *

- Area Code Phone Number

E-mail

Godparent #1 Name:

First Name Last Name

Godparent #1 Address:

2. Godparent #2 Name:

First Name Last Name

Godparent #2 Address: