APPLICATION FORM INQUIRING ABOUT HAVING YOUR HOME BLESSED BY A PRIEST

THIS IS A SIMPLE BLESSING BY A PRIEST TO DEDICATE ONE'S HOME AND FAMILY TO GOD'S CARE

Once you have filled out this form, we will contact you to confirm the arrangements and time and place

GIVEN NAME OF APPLICANT: *

ANY (AND ALL) MIDDLE NAMES OF APPLICANT: (PLEASE LEAVE BLANK IF NO MIDDLE NAMES):

NAME THAT THE APPLICANT IS USUALLY KNOWN BY: (EG: WILLIAM=BILL):

Email Address:

any specific date or time you are looking at? We will have to check if we are available at any proposed dates and confirm it once we have checked:

ADDRESS OF THE PLACE YOU WISH BLESSED: *

please write here any information that will help us to find the address if it might be difficult to find:

How long have you lived at this place and what is the reason for you wishing to have your home blessed at this time:

POSTAL ADDRESS (IF DIFFERENT FROM RESIDENTIAL) *

my postal address is the same as above

I have a postal address: I have a postal address:

Best contact Phone Number: *

Home phone number if different from above:

Please write the name of the person filling out this form *

PLEASE SELECT THE BLESSING YOU ARE SEEKING *

BLESSING OF MY HOME

BLESSING OF A BUSINESS PREMISES THAT I OWN AND OPERATE

OTHER OTHER

PLEASE LIST ALL THE NAMES OF THE PEOPLE WHO LIVE AT THIS ADDRESS, (OR PEOPLE WHO YOU WOULD LIKE INCLUDED, BY NAME, IN THE BLESSING PRAYERS). PLEASE WRITE IN BRACKETS THEIR RELATIONSHIP TO YOU, EG SPOUSE, CHILDREN, YOUR PARENTS, BROTHERS OR SISTERS: *

IF THERE ARE OTHER PEOPLE WHO WILL BE PRESENT AT THE BLESSING WHO DON'T LIVE AT THE HOME BUT WOULD LIKE INCLUDED BY NAME, PLEASE WRITE THEIR NAMES HERE AND PUT IN BRACKETS THEIR RELATION TO YOU: (EG - RELATIVE, PARENT, FRIEND, NEIGHBOUR).

ANY OTHER INFORMATION YOU WOULD LIKE TO LET US KNOW: