Extraordinary Ministers of Holy Communion Annual Recommitment

Personal Information

Name

First Name*

Last Name*

Address

Street 1*

Street 2

City*

State*

Zip*

Phone

Required* --

Are you currently married?
Required*

	Yes
	No

If you are married, was the marriage in the Catholic Church?
Required*

Ministry

Select one:
Required*

	Yes, I will recommit myself to serve as a minister of Holy Communion at Nativity Parish for one more year.
	No, I do not want to recommit myself as a minister of Holy Communion beyond August 31 of this year.

Indicate all the areas of your CURRENT ministry:
Required*

	Hospital
	Home Bound
	Nursing Home
	Daily Mass (Monday thru Saturday mornings)
	Life Teen

	Spanish Mass (Saturday or Sunday mass)
	Saturday Afternoon Mass in English
	Sunday Morning Family Mass in the Chapel
	Sunday Morning (in the main Church)

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Signature

Submitting this form constitutes a signature and by signing, you are confirming that you are the individual listed above.

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