Name *

First Name

Last Name

Phone *

(###)

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Are you planning on attending or did you attend the training for EM's on October 14th? *

Yes

No

Are you currently an Extraordinary Minister of Holy Communion at Mass? *

Yes

No

Have you brought the Eucharist to homebound parishioners in the past? *

Yes

No

Select Available Times *

Monday Morning

Monday Afternoon

Tuesday Morning

Tuesday Afternoon

Wednesday Morning

Wednesday Afternoon

Thursday Morning

Thursday Afternoon

Sunday Morning

Sunday Afternoon