Address of Parish/Institution *
Address of Parish/Institution
Are the Candidates fully initiated Catholics of at least 18 years of age? *
ie. Baptism, Eucharist, Confirmation
Are the Candidates practicing Catholics in good standing with the Church? *
I verify that as Pastor I will provide adequate training for appointed Extraordinary Ministers of Holy Communion. *
Date *
Date
1. Name *
1. Name
1. Type of EMHC *
How will this person be serving as an extraordinary minister of holy communion?
2. Name
2. Name
2. Type of EMHC
3. Name
3. Name
3. Type of EMHC
4. Name
4. Name
4. Type of EMHC
5. Name
5. Name
5. Type of EMHC
6. Name
6. Name
6. Type of EMHC
7. Name
7. Name
7. Type of EMHC
8. Name
8. Name
8. Type of EMHC
9. Name
9. Name
9. Type of EMHC
10. Name
10. Name
10. Type of EMHC
11. Name
11. Name
11. Type of EMHC
12. Name
12. Name
12. Type of EMHC
13. Name
13. Name
13. Type of EMHC
14. Name
14. Name
14. Type of EMHC
15. Name
15. Name
15. Type of EMHC
16. Name
16. Name
16. Type of EMHC
17. Name
17. Name
17. Type of EMHC
18. Name
18. Name
18. Type of EMHC
19. Name
19. Name
19. Type of EMHC
20. Name
20. Name
20. Type of EMHC

If you would like to submit more than 20 persons, please fill out the form a second time.  Thank you!