JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Sick / Death / Death Anniversary List Request
We take requests up to 4 weeks in advance
Sign in to Google
to save your progress.
Learn more
* Indicates required question
I would like to submit a prayer request for:
*
List Name of person to be prayed for.
Your answer
Is this person a Parishioner of Resurrection
*
Yes
No
This person is or has
*
Sick
Died
Death Anniversary
Deceased Birthday Remembrance
Other information you would like to submit regarding this person:
For example: 10 Year Anniversary of Death, In Palliative Care etc.
Your answer
Mass / Service you would like this person remembered on?
Select either a Weekend Mass or Weekday Mass / Communion Service. NOTE - Mass is celebrated on Wednesday and Friday. A Communion Service is held on Tuesday and Thursday.
Weekend Mass (up to 5 weeks in advance)
3 June / 4 June 2023
10 June / 11 June 2023
17 June / 18 June 2023
24 June / 25 June 2023
1 July / 2 July 2023
8 July / 9 July 2023
15 July / 16 July 2023
Clear selection
Nominate specific Mass you would like your intention prayed at:
Use this section for Death or Anniversary names.
6.00pm
9.00am
11.00am
Clear selection
Alternatively you can select a specific Weekday Mass / Communion Service Date
If Sick, the person's name will automatically go on the list for 4 weeks.
MM
/
DD
/
YYYY
Name of Person Submitting Prayer Intention
*
Your answer
Your Phone Number
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Resurrection Catholic Church Keysborough.
Report Abuse
Forms
