Extraordinary Minister of Holy Communion
_____________________ ____________________________ ______________
First Name Last Name Application Date
___________________________ ________________________ _____ ____________
Mailing Address City State Zip Code
_______________________ ________________________ _____________________
Home Phone Work Phone Other
_______________________ ________________________
Email Address Nbr. Years at St. Francis
Are you currently employed? ¨ Employed ¨ Retired ¨ Other____________________
Marital Status? ¨ Single ¨ Married ¨ Divorced
If married, where and what year? _____________________________________
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As you may know, according to the guidelines of the Church, Extraordinary Ministers of the Eucharist
must be commissioned by the Pastor, as directed by the Bishop. In these days of secularism, we must
firmly believe in the Real Presence in the Eucharist and be good practicing Catholics (e.g. attend Mass
weekly and frequent use of the Sacrament of Penance). We must always distribute the Body and
Blood of our Lord, Jesus Christ with the utmost honor and reverence.
Have you ever served as an Extraordinary Minister of the Eucharist in another parish? ¨ Yes ¨ No
If yes, where? ___________________________________________________
Which Mass do you regularly attend? ¨ Sat. 5:30 ¨ Sat. 7:00
¨ Sun 7:30 ¨ Sun 9:00 ¨ Sun 10:30 ¨ Sun 12:15
Are you interested in bringing Communion to the sick? ¨ Yes ¨ No
If yes, which day(s) would you be available? ________________________________________________
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