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Our monthly newsletter subscription is FREE for the FIRST YEAR for all who would like to receive it. 

After that, the cost to renew* is just $17.00/yr for the printed and mailed version.

If the email version is chosen, there is no charge for renewals but we will send out a renewal form when the anniversary of the subscription approaches so the subscriber can let us know if they would like to continue to receive future issues.

Please complete all fields below. This information is for our use only and will not be shared with any other organization or company without permission.

If you would prefer that we not publish your family's information on the Prayer Page of our monthly newsletter or if there are ADDITIONAL family members that you would like us to mention, please make a note of this in the comments field below.

NOTE: Use the TAB key to move between fields. If the ENTER key is used it will submit the form.

*Subscription renewal "grants" are available to pay for renewals for those who are experiencing financial hardship.

Subscriber Name:
Address: Apt #:
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City: State: Zip or Postal Code:
Country:
Email Address: (ex: someone@service.com)
Note: Be sure to include the '@' sign and the information after it in your email address. Thanks.
( Please check the accuracy of your email address before submitting.)
Check here if you would prefer to receive our newsletter via email.
Please select your preferred e-mail newsletter format below.
Email Newsletter Format Preference:
Text       Acrobat .PDF Attachment       Link to Acrobat .PDF file
Phone Number:
Name of Child Who Died:
Your Relationship to the child that died:
Gender: Boy    Girl
Birthdate:
Date of Death:
Cause of Death:
Names of Surviving Brother(s):

Names of Surviving Sister(s):

 

In case of Additional Losses:
Name of Person Who Died:
Your Relationship to this Person:
Gender: Boy    Girl
Birthdate: 
Date of Death:  

Cause of Death:

 

Name of Person Who Died:
Your Relationship to This Person:
Gender: Boy    Girl
Birthdate: 
Date of Death:  

Cause of Death:

 

Comments:
Please enter any comments you would like to include. Any questions you may have can also be included here.
 

 

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