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  • Deacon Full Name REQUIRED Please fill out this field. Please enter valid data.
  • Current Residential Address of Deacon Requesting LOS REQUIRED Please fill out this field. Please enter valid data.
  • Location of Current Assignment REQUIRED Please fill out this field. Please enter valid data.
  • Email of Deacon Making Request REQUIRED Please fill out this field. Please enter an email address.
  • Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  • Current Status REQUIRED Active Retired Please fill out this field.
  • Arch/Diocese you will be visiting REQUIRED Please fill out this field. Please enter valid data.
  • Country you will be visiting, if applicable Please enter valid data.
  • Event Location REQUIRED Please fill out this field. Please enter valid data.
  • Event Start Date REQUIRED Please fill out this field. Please enter a date.
  • Event End Date REQUIRED Please fill out this field. Please enter a date.
  • Chancellor/Vicar General of Visiting Diocese REQUIRED Please fill out this field. Please enter valid data.
  • Contact Person in Diocese you'll be visiting REQUIRED Please fill out this field. Please enter valid data.
  • Email address of contact person REQUIRED Please fill out this field. Please enter an email address.
  • Full Mailing Address of Visiting Diocese REQUIRED Please fill out this field. Please enter valid data.
  • Will you be serving at a Mass? REQUIRED Yes No Please fill out this field.
  • Will you be Officiating a Wedding? REQUIRED Yes No Please fill out this field.
  • If yes, please provide names of Bride and Groom Please enter valid data.
  • Will you be baptizing a child? REQUIRED Yes No Please fill out this field.
  • If yes, please provide name of the child Please enter valid data.
  • Will you be Serving at a Funeral? REQUIRED Yes No Please fill out this field.
  • If yes, please check all that apply Officiate-Funeral Services Preside-Committal Services Preside-Vigil Assist a Funeral Mass
  • If yes, please provide name of deceased Please enter valid data.
  • Will you be presenting? REQUIRED Yes No Please fill out this field.
  • If yes, please provide presentation details

    What you will be presenting on

    Please enter valid data.
  • Select the Type of Event Special Event Vacation Retreat Pilgrimage Other

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