Divine Word Missionaries
Your Mass Card Requests

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Mass Card Request & Enrollment Form

Select an image that will go inside the Mass Card folder
  
  
Choose appropriate enrollment:
  
-  Individual $30.00 (if you wish to enroll one person, write that person's name here)
First name Mn Last name
   
  
or
  
-  Family $40.00 (if you wish to enroll an entire Family or multiple persons listed by names, write the Family or individuals' names here -all on one certificate)
Indicate deceased persons by a plus sign + before the name
  
Requested by: (your name as it is to appear on the certificate)
    

  

If you wish us to send this certificate to an address different than the billing address, write that person's name and address below:
 

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