Mass Intention Request Form - Saint Michael Church

Mass Intention Request

** Please Note: Requests will not be filled until payment has been received. This form should only be used if you plan to use online payment once submitting your request. Instructions to complete your payment online will be given upon submitting the form. **Please note: Only ONE request may be submitted at a time. For multiple requests, please complete a form for each request, or stop by the Parish Office during regular business hours. Thank you!

Today's Date*
MM slash DD slash YYYY
Your Name*
First Last
Phone*
Email*
Name of Person for whom Mass is being requested*
Would you like your name published with the request? If so, how would you like it listed? (example: unlisted, The Taylor Family, Richard Jones)
Is this person living or deceased?*
- Living (Special Intention)
- Deceased (Repose of the Soul)
Below list 3 dates you would like for us to check (if the dates are not available, we will choose the closest available date). You may also state "Next 12:30pm Sunday Mass or next available weekday Mass" instead of a date.*
If you would like for us to send a card, please list the name and full mailing address of the person to which you would like the card sent:
Mass Intention Stipend*
Price:
How will you pay?*
- Online Payment (follow instructions provided on next screen after you hit submit)
* Please note: Requests are NOT added until payment is received.
Name
This field is for validation purposes and should be left unchanged.

Mass Intention Request

Today's Date*
MM slash DD slash YYYY
Your Name*
First Last
Phone*
Email*
Name of Person for whom Mass is being requested*
Would you like your name published with the request? If so, how would you like it listed? (example: unlisted, The Taylor Family, Richard Jones)
Is this person living or deceased?*
- Living (Special Intention)
- Deceased (Repose of the Soul)
Below list 3 dates you would like for us to check (if the dates are not available, we will choose the closest available date). You may also state "Next 12:30pm Sunday Mass or next available weekday Mass" instead of a date.*
If you would like for us to send a card, please list the name and full mailing address of the person to which you would like the card sent:
Mass Intention Stipend*
Price:
How will you pay?*
- Online Payment (follow instructions provided on next screen after you hit submit)
* Please note: Requests are NOT added until payment is received.
Phone
This field is for validation purposes and should be left unchanged.