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Home / National Shrine Home Page / Tours & Pilgrimages / Bus Registration
Group Registration Form
Please submit your bus registration before your pilgrimage date.
Group or Parish Name:
Number of people anticipated on each bus:
Number of busses:
Total:
Pilgrimage date:
If you are coming for the Mercy Sunday Weekend (April 18 & 19, 2009),please use our Divine Mercy Weekend Bus Registration Form.
Primary language(s) spoken by your group:
Will you want to use Memorial Hall? Yes No
Will you want to use the Mother of Mercy Outdoor Shrine? Yes No
Will you want a tour and talk of the Shrine? (11:00 AM only) Yes No
Will you like to celebrate a Mass? Yes No
Name of Priest(s) with your group:
(All visiting priests who wish to concelebrate Mass or hear Confessionsmust present credentials at the Shrine Reception area upon arrival.)
BOX LUNCH ORDER
$7.50 each
Lunch includes deli sandwich, fruit,chips, dessert & bottled water
Ham
Turkey
Tuna
Total
Orders must be finalized at least 10 days prior to your visit.
Comments (optional):
Card Number:
Expiration Date Month 01 02 03 04 05 06 07 08 09 10 11 12 Year 08 09 10 11 12 13 14 15 16 17 18
Security Code
Title
Archbishop Bishop Br. Captain Cardinal Chaplain Chief Colonel Commmander Corporal Deacon Dr. Fr. General Judge Ks. Lance Corporal Lt. Lt.Col. Major Major and Mrs. Miss Monsignor Mother Mr. Mr. and Mrs. Mr. and Dr. Mrs. Ms. O. Padre Private Pral. Prof. Rev. Senator Sergeant Sr.
*First
*Last Name
Suffix
II III IV CPA DDS DMD Esq. Family Jr. MD PhD RN Sr.
*Address
*City/Town
*State/Province
*Zip/Postal Code
-
*Country
*Email
*Daytime Phone
First
Last Name
Address (We can not ship to PO boxes)
City/Town
State/Province
Zip/Postal Code
Country
Email
Daytime Phone
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