St. Ann Catholic Church – 561-832-3757
|Parish Name of the Sponsor ______________________________________________
Parish Mailing Address______________________________________________________________
City, State, Zip _________________________________________ Phone (_____) ______________
To the best of my knowledge, this person is able to fulfill the responsibilities involved in sponsoring the Catholic initiation of another. Yes No Other (comment on reverse side)
At this parish, I serve as (circle one) Pastor, Priest, Deacon, Lay Ecclesial Minister. I am authorized to make this statement about our parishioner.
Printed Name _________________________________
Signature ____________________________________ Date _____________________