Extraordinary Minister of Holy Commuion Form

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

PLEASE RESPOND TO THE FOLLOWING STATEMENTS:

I am sixteen (16) years of age or older. REQUIRED Yes No Please fill out this field.
I am a Baptized Catholic. REQUIRED Yes No Not Sure Please fill out this field.
I have received the Sacrament of First Holy Communion. REQUIRED Yes No Not Sure Please fill out this field.
I have received the Sacrament of Confirmation. REQUIRED Yes No Not Sure Please fill out this field.
I regularly attend weekend Mass and Mass on Holy Days of Obligations REQUIRED Yes No Not Sure Please fill out this field.
I am in a marriage or non-married situation that confirms a Catholic teaching. REQUIRED Yes No Not Sure Please fill out this field.
I have received the Sacrament of Reconciliation once or more during the past twelve months. REQUIRED Yes No Not Sure Please fill out this field.
Please note that lay ministers, if they are not already doing so, are encouraged to participate in the sacrament of Reconciliation on a regular basis, and to participate in faith enrichment opportunities available in the parish or diocese.

WEEKLY MASS PREFERENCE:

Which Mass or Masses are you willing to serve? REQUIRED Saturday, 5:30 PM Vigil Mass Sunday, 8:00 AM Mass Sunday, 10:00 AM Mass Sunday, 12:00 PM Mass Sunday, 5:00 PM Youth Mass Please fill out this field.
Are you willing to service more than once per month? REQUIRED Yes No Please fill out this field.

HOSPITAL/HOMEBOUND

Would you be willing to help with Communion distribution for home-bound, nursing homes, and hospitals at least once per month? REQUIRED Yes No Please fill out this field.
Have you attended Protecting God's Children training with the Diocese of St. Augustine? REQUIRED Yes No Please fill out this field.

I Agree Please select this field.