1. Sanctuary Lamps (2) Papal Blessings (3) Special Occasions/Blessings

Complete the appropriate section(s)
Today’s Date: ________________________________
Requestor’s Name:______________________________ Phone #:____________________

1) Sanctuary Lamp:   Week requested_______________ Lamp # _______

$15 Paid: Cash_____ Check #_______

Name(s) on lamp: □ Living   □ Deceased ___________________________________________________________________________Card requested   □ Yes    □ No              

Special instructions ______________________________________________________________________

$50 Paid: Cash_____ Check #_______

2) Papal Blessing:Note: Give office at least 1 months’ notice to process your request
Circle # of years:    10^th, 25^th, 30^th, 40^th, 50^th, 60^th, 70^th
Name(s) printed on document: ____________________________________________________________________________________
                                                                                                                 (Write exactly how you want it printed)
If an anniversary, the actual date of the wedding: ______________________________________________________
□ Pick up in office    □ Present at Mass     Required # of Pews:  left side: ____________ right side: _____________
Mass date requested: _____________________________________ Mass time: _____________

Special instructions ______________________________________________________________________

3) Special Occasion Blessing:

□ Wedding Anniversary (years married) _________ □ Memorial   □ Birthday    □ Other ___________________
Mass date requested: __________________________________ Mass time: ______________
# of Reserved Pews: left side: _________ right side: ___________

Special instructions ____________________________________________________________________           

For Office Use Only (initial/date when entered as indicated)
Mass Intentions      ______ _________ Mass Book/spreadsheet (01/Visitor volunteer/mass Intentions Stipends Black Book)
Sanctuary Lamp     ______   _________ Mass Book/spreadsheet    

Blessing                      _______    ___________ Mass Book (right side)
Computer                 _______   _________ Pgray U: drive