The Parish of St. Theresa

Little egg harbor, new jersey

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Mass Intention Request Form

- Mass Intention Request
  
  2027
  
  Note: Due to the great number of requests for "Announced Masses" and an increased number of parishioners, Mass Intention requests are now limited to 2 (two) per family per year and accepted by the parish office using the online or print forms only.
- This form is not accepting responses at this time.
  
  Person filling out this form:
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email Please enter an email address.
  
  Requested Mass #1
  
  Mass Date REQUIRED Please fill out this field. Please enter a date.
  
  Mass Time REQUIRED Please fill out this field.
  
  Intention REQUIRED Please fill out this field. Please enter valid data.
  
  Requested by: REQUIRED Please fill out this field. Please enter valid data.
  
  Requested Mass #2
  
  Mass Date Please enter a date.
  
  Mass Time
  
  Intention Please enter valid data.
  
  Requested by: Please enter valid data.
  
  No personal Masses will be scheduled on Mother's Day, Father's Day, Thanksgiving, Christmas, or Easter
  I Understand Please select this field.
  
  Submitting this form does not guarantee your choices. Mass selections are not confirmed until you receive a call or email from the parish office.
  I Understand Please select this field.
  
  A stipend of $10 per Mass will be payable after Masses are confirmed.
  I Understand Please select this field.
  
  Submit

Mass Intention Request Form

Person filling out this form:

Requested Mass #1

Requested Mass #2