Mary Our Mother Foundation, Inc. -- Messenger for MOM Acceptance Form

"Messenger for MOM" Acceptance Form

Please print out and mail in. All fields must be filled in.

I wish to become a "Messenger for MOM" and help spread the messages.
I wish to order the following display stand(s):

# OF STANDS	DISPLAY STAND OPTIONS
	Divine Mercy, An Invitation
	Medjugorje (Vols. 1, 2, 3 & 4) and Holy Rosary CD
	Holy Rosary CD with Divine Mercy
	Combination Stand (All Titles)
	Llamado a la Oración - Mensajes de Medjugorje (Spanish)

Please send the display stand(s) and CDs to:

Name:
Address:
City:	State:	Zip:
Email: (if available)	Phone:

Note: To display the CDs in your church, we ask you to please obtain the permission of your pastor.

Name of Church:
City:	State:

I understand and agree to:

Maintain and refill the display stand as needed.
Return all donations received to Mary Our Mother Foundation.
Write one check for cash donations received made payable to Mary Our Mother Foundation.

There is a required donation of $40 per display stand. To join us in our efforts, please mail the acceptance form and a check made payable to “Mary Our Mother Foundation” to:

Mary Our Mother Foundation
PO Box 4257
Alpharetta, GA 30023

Thank you for your kindness and support in helping to spread the messages of Our Lord and Lady!