This text gets replaced by the swf file if the user has Flash installed.

Family Ministries

Diocesan Anniversary Celebration Registration Form

 

August 3, 2008, Our Lady of Mercy, Erie, 2:00 p.m.

August 10, 2008, St. Tobias, Brockway, 2:00 p.m.

I regret that I cannot attend the anniversary celebration.  Please send scroll instead.

Husband's First Name as you want it to appear on the scroll
 
Bride's First Name
Last Name
Street Address
City/State/Zip
Phone Number with Area Code
E-mail Address
 
Present Parish (Please include City)
Date of Marriage:    Use  MM/DD/YYYY format.
Anniversary you are celebrating:  60     50th      25th

Wheelchair/disable seating needed

Walker/cane

Sign Language interpretation needed