Knights of Emmanuel 
Pledge Form


 

Please complete the following information in its entirety.

Then print to mail or fax ,or press "submit form" to send via email.

Guardians of the Eucharist

Please select any of the following choices:

Level I Kinght of EmmanuelLevel II Knight of the Round Table Level II White Knight

Please provide the following information:
 
Today's Date MM/DD/YY
FIRST NAME
LAST NAME
MIDDLE NAME
E-MAIL ADDRESS
ADDRESS
CITY
COUNTRY
STATE/ZIP
PHONE
FAX
BISHOP
DIOCESE
PASTOR
CHURCH PARISH
CHURCH ADDRESS
CHURCH CITY
CHURCH STATE/ZIP
CHURCH PHONE
CHURCH FAX

 

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          All personal or confidential information entrusted to the Miracle of the Rosary Mission will not be disclosed to anyone at anytime for any reason. Trust is difficult to attain and easily lost. We are committed to protecting your privacy. We are humbled by the trust you have placed in us and promise to maintain it.

Miracle of the Rosary Mission
1444C Highway 1 Thibodaux LA 70301-5748 Tele (985) 448-3787 Fax (985) 488-2175
ContactUs@MiracleRosaryMission.org

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