REQUEST FOR DIVINE LITURGY

St. Anne Ukrainian Catholic Church

1545 Easton Road - Warrington, Pa 18976

PLEASE FILL OUT IN FULL - PRINT CLEARLY

I/We would like to request that a Divine Liturgy be said for:

______________________________________________________________________

(print name)

For the Following Purpose:  Check One

[ ] In memory of deceased person(s)

[ ] In memory of deceased person(s) with Panachyda*

[ ] For God's Blessing and Health

[ ] Special Occasion (check one)

     [ ] Birth of Child   [ ] Baptism/Chrismation/Communion   [ ] First Confession

     [ ] Graduation from ______________  [ ] Wedding Anniversary ___Years

     [ ] Other:_______________________________

*Panachyda is a Special Service for Deceased at the end of Divine Liturgy

PLEASE SAY DIVINE LITURGY ON:  [ ] Saturday 7 pm  [ ] Sunday 9 am

                                               [ ] Weekday 7:30 am

OR: **Specific Date(s)_______________________________________________________

**Father will try to give you requested date but if it has already been reserved, he will notify you of another available date.

I/We have enclosed $________as a Donation

Requested by:  Name:__________________________________

                     Phone #:________________________________

Check One: 

[ ] Please mail card to:   Name:________________________________________

                                 Address:______________________________________

[ ] I will mail the card myself by/ [ ] Pick up card after Liturgy/ [ ] Pick up card at Rectory (call 215-343-0779)