MASS INTENTION REQUEST
The Office of Mission and Ministry offers Masses for those who are deceased and for the special intentions of those who are living. Mass intentions are offered at the 12:10pm daily Mass in Dahlgren Chapel. If you would like to request a Mass, please fill out the form below.

Because of the number of requests received, intentions are usually scheduled at least 5 months after the request is made.

Intention Information
Who will the Mass be offered for? *
Your answer
In order to help the Priest say the name of your loved one correctly, you may include its pronunciation here.
Your answer
Type of Request *
Required
If you have requested a Special Intention, please indicate the need, e.g., health, in gratitude
Your answer
If you would like the Mass offered on a particular date, please indicate the date below (if available)
Your answer
Requested by *
Please indicate who is requesting the intention. This name will appear on the Mass Card.
Your answer
Delivery *
Please select how you wish to receive this Mass Card
If you request the Mass Card to be mailed, please provide a full address below (with addressee)
Your answer
Please indicate if you or the individual's family will be attending the Mass *
Name of family/friends attending
Your answer
Additional Comments
If you have any additional requests for this Mass Card, please write these below.
Your answer
Your Contact Information
Contact Name *
Your answer
Contact Number *
Your answer
Contact Email *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Georgetown University.