If you will be relocating to Belgium (or have already), we hope that you will join us. use the online form or instead, print out the form and leave ir either at the Parish Center, or at the church.

On Line Registration Form

or use this MS Word version and email to information@olm.be

Family Name:

Single or Man's Name:

Birthdate:

Catholic?   Yes

   Other:

  Wife & Maiden Name:

         Birthdate:

Catholic?   Yes

   Other:

Wedding Anniversary:

 

Address in Belgium:

Street:

Number:

    Box Number:

  Town:

Postal Code:

E-Mail Address:

      Home Phone:

                      Fax:

Business Phone:

Country of Citizenship:

If known, how long will you be in Belgium?

 

Children's Names

Date of Birth

Baptised

School

Grade

1.

Y N

2.

Y N

3.

Y N

4.

Y N

     

Employer and Business Address:

Employer:

Street:

Number:

    Box Number:

  Town:

Postal Code:

How did you learn about Our Lady of Mercy?

Other Items (Use this space for children details if more than 4):
 


You probably will encounter an error message. Rest assured your form has been sent.
If in doubt, please send me an email to webmaster@olm.be