AMM | Christmas Remembrance and Petition Form

Burn a Votive Light | How to Donate | Contact Us

Dear Father Grodecki,
Please remember my intentions in the Masses offered at the Shrine—especially during the Christmas Novena, December 16 - December 24.

Shrine altar

Peace on Earth	Thanksgiving	Family
Return to Sacraments	The Poor	Alcoholism or Drug Problem
Employment	Financial Needs	Safe Travel

Special Intentions

Light a Votive Light for all your Intentions: What a burning candle means

Please remember these names in the Mass offered at the Shrine—especially during the Christmas Season. You may also burn a Votive Light for them.

Names to be remembered	Votive Light to burn at the Shrine

Make a Christmas donation to help the Association and support Vincentian ministries.

I WISH TO MAKE A DONATION OF:
	$25.00
	$50.00
	$75.00
	$ (any amount not listed above)
	None Selected

Your Name and Address:
Title: (Mr., Mrs., Miss, Rev.)
First Name:
Last Name: Suffix:
How would you like us to address you? ("Dear Pat") Dear
Email address:
Postal Address:
(second line...)
City: State:
ZIP/Postal code
Are you already on our mailing list? Yes No
If so, what is your member number? What's this?
(If you don't know or can't find your donor number, we can still process your request)
Would you want to receive emails from us? Yes No

If you experience any difficulties during your ordering process, please call us at 1-800-264-MARY (6279).

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