St. Leonard's Parish

Mass Intention Request Form

Mass Intention Request
Request Submission Date
- Month - Day at Year / Hour Minutes
Requestioner Name*
First Name Last Name
E-mail*
Phone Number*
- Area Code Phone Number
Mass Intention
Mass for:*
First Name Last Name
Status*

Deceased Living
Date and Mass Time Requested*
- Month - Day at Year / Hour Minutes
Comments
Instructions

The Mass stipend for an announced Mass is $15.00. You may drop your offering in the collection basket on Sunday. Please make sure the envelope is clearly marked with you name, phone number, who the Mass is for and the date requested.
Should be Empty:

Mass Intention Request