Contact information

Birthdays & Anniversaries


The information you provide on this form will be held in strict confidence.  It is
only used to update our council records so that we can always contact you.
The dates you provide allow us to wish you or your wife a 'Happy Birthday'
or extend anniversary greetings to you and your wife in our monthly newsletter
 "The Lance".  (Wives age or year of birth is never printed.) 
Thanks for your help and your understanding.

Please provide the following contact information:

First Name
Middle Initial
Last Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Home Phone
E-mail
Date of Birth

Please enter your wife's information:

First Name
Middle Initial
Last Name
Date of Birth

What parish do you belong to:


Enter date you were married:



 
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Revised: 12/03/07