Saint Rose of Lima Catholic Church
Bulletin Notice:  Request Form  

Bulletin notices are a brief public notice. Notices will run for two weeks consecutively ONLY.  Please print this form, neatly print the required information for your bulletin notice request, and return the form to the St. Rose Parish Office. There are a number of Ministries using our bulletin as a vehicle to get their message out, so please be brief.  Bulletin requests must be received by Monday at 8:00 AM to be considered for the following Sunday's bulletin. The office staff reserve the right to edit the message for size before publishing to the bulletin.

Please run bulletin message for:  ____ 1 week    ____ 2 weeks

Requestor Information:

Group Name:  

Requestor Name:

Address:

Street:  

City:                                                                   State:                                               Zip:   

Phone Number: 

Email address:

Bulletin Notice Information:

Title Line:

 Event Name:

 Event Date:

 Event Time:

 Event Location:

 Event Contact Name:

  Event Contact Phone Number:

Additional Information:

Brief Note to Office Staff (Not included in Bulletin Message):