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Memorial Day Petition Form
 
 
 
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Dear Father,

Please remember my intentions and my beloved deceased at our Lady's Shrine.

Name Votive Light
Name Votive Light
Name Votive Light
Name Votive Light

Family Thanksgiving Peace on Earth
Respect for Life The Poor Peace of Mind
Employment Financial Needs Armed Forces
Conversion Marriage Devotion to Mary

Special Intentions

Light a Votive Light for your Intentions: (What a burning candle means)

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 yes, what is your member number? What's this?
(If you don't know or can't find your member number, we can still process your request)

Would you want to receive emails from us? Yes No

Return to the start of the petition slip.
navy ball Honor a loved one through the Association's Tribute Program.
navy ball Read a Memorial Day Remembrance prayer.
navy ball Read the story of Memorial Day.
navy ball Send an e-card to someone in the military. 
navy ball Send a donation to the Miraculous Medal Association.
navy ball Return to the Memorial Day letter.