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2010 Pre-Cana Registration Form

(Please print  legibly—Your Certificate will reflect accordingly)

**Note: Confirmation of registration will be only sent electronically .  Please provide email address

   Name of Groom:____________________________________________________________________________________________

   Name of Bride (Maiden):_____________________________________________________________________________________

   Address Correspondence To: _________________________________________________________________________________

   Telephone: Day_____________________________ Evening  ________________________________ Email________________________________  

   Religion of Bride:___________________________________     Groom:_______________________________________________

   Wedding Date:_________________________     Parish:________________________________________________________ 

        2010 Dates: January 10_____ February 21 _____ March 14 _____ April 11 ____   May 16 _____ June 6_____  June 13_____   July 11 _____

        July 25 _____    August 8_____  October 10 _____                  

 Cost - $70 per couple:  ENCLOSED ___________     DISCOVER/MASTERCARD/VISA  (Circle One)  Signature                                                               

    ____________________________________________________         ______________________________________________________                     ______________________

       NAME ON CARD                                                         ACCOUNT NUMBER                                                             EXP. DATE 

 

 

 

                                                                                                                                                                                                              


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