Family Ministries

Diocesan Anniversary Celebration Registration Form

 

Which anniversary celebration do you wish to attend?:

Names exactly as you wish them to appear on the scroll

Husband's First Name :  

Wife'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 or more years? Please indicate exactly how many years:

Wheelchair/disable seating needed

Walker/cane

Sign Language interpretation needed