St Theresa Parish Directory Information Form

35 South Main Street, Sherborn, MA 01770
Office: 508-653-6253 Fax: 508-651-8798

Parish Directory Information Form 2006

1. Contact Information

Full Name #1
Full Name #2
Mailing Address
City
State, Zip
Telephone	home cell
E-Mail #1
E-Mail #2
E-Mail #3

OPTIONAL INFORMATION

Please list any additional family members that you would like to include in the directory:

Name:
Name:
Name:
Name:
Name:
Name:

Please check one of the following statements:

I want this information to be published in the 2005 Parish Directory
I do not want this information to be published in the 2005 Parish Directory. I do want the
       parish to have my information for Parish purposes and mailings.