Prayer Enrollment Request Form

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Prayer Enrollment Request Form
Dominican Nuns, Dominican Monastery of St. Jude, Marbury, Alabama
Your Information
Name: _______________________________________________________________________________
Address: _____________________________________________________________________________
Street Address
_____________________________________________________________________________
City
State
Zip code
(Country)
E-mail address: ________________________________________________________________________
(We will contact you by e-mail if we have any questions about the enrollment.)
Would you like to receive our twice-yearly newsletter?
__ yes, please
__ no, thank you
Enrollment Information
Enrollment Type: __ Perpetual Enrollment
__ Remembrance in Prayer
Name of person to be enrolled: ___________________________________________________________________
__ Living __ Deceased
If deceased: Relationship of the deceased to the person to whom the enrollment is to be given:
______________________________________________________________________________________
For example: “For your beloved husband/wife, grandmother, friend”
If living: Occasion/Intention: ______________________________________________________________________
For example: “On the occasion of your anniversary” or “For your health”
Enrolled by: ___________________________________________________________________________________
If possible, please send the enrollment so it will reach the recipient by this date: ____________________________
Mailing Information
__ Please send the enrollment card to me at the address above: __ single envelope (if for you)
__ double envelope (if for someone else)
__ Please send the enrollment card to the address below:
Name: _______________________________________________________________________________
Address: _____________________________________________________________________________
Street Address
_____________________________________________________________________________
City
State
Zip code
(Country)
My donation of $______________ is enclosed. (Please make checks payable to Dominican Monastery of St. Jude.)
(The suggested donation for the Perpetual Enrollment card is $20; for the Remembrance in Prayer card, $10.)
Please send the completed form along with donation to:
Dominican Nuns, Dominican Monastery of St. Jude, 143 County Road 20 East, Marbury, Alabama 36051.
We will send the enrollment as soon as our schedule permits. Thank you. Be assured of our prayers.

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