Donations - form

Our Lady of Czestochowa, Pray for us!
SHRINE OF OUR LADY OF CZESTOCHOWA

Pauline Fathers
PENROSE PARK,
BERRIMA NSW 2577
Phone: (02) 4878 9192

I wish to be included among the friends and benefactors of Our Lady's Shrine in Penrose Park.

NAME: ...........................................................................................................................................................................

ADDRESS: ..................................................................................................................................................................

CITY: ........................................................................................... STATE: ......................... POSTCODE: ................

Donation $ .......................................................................

Mass intention $...........................................................................................................................................................

Virgin Mother, from your holy Shrine, draw all God's children to your laving care and protector!

Print this form and return
Please return completed form to:
 PAULINE FATHERS' MONASTERY
 "PENROSE PARK"
 C/- POST OFFICE
 BERRIMA, N.S.W. 2577

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©PAULINE FATHERS MONASTERY
"Penrose Park" NSW Australia, 1999
URL of this page: http://paulinefathers.org/eng/form1.htm

Last updated
by [Ryszard Majchrzak]