Wine, Host , Sanctuary Lamp Request Form

Wine, Host, and Sanctuary Lamp Request Form

Please place in collection basket or mail to:

Christ Our Hope RC Parish

1762 French Creek-Mina Rd, Clymer, NY 14724

If you would like to donate the wine or hosts for a specific month in memory of a loved one or you would like to
have the Sanctuary Lamp lit for a special intention during a specific week, please complete the form below and
drop it in the collection basket along with the required stipend. The intentions will be printed in the Sunday
bulletin. We will try to honor all requests. Please print clearly - circle “In Memory of”’ or “In Honor of.’’

Hosts ($25/mth) Memory of/Honor of: _____________________________________________

Wine ($25/mth) Memory of/Honor of: ______________________________________________

Sanctuary Lamp ($5/week) Memory of/Honor of: _____________________________________

Contact Name ________________________________________________________________

Month being requested for wine/hosts: _______Week requested for sanctuary Lamp: ____________