Update Records Form

Black And Indian Mission Office
2021 H Street, NW
Washington, DC 20006-4207
(202) 331-8542
www.blackandindianmission.org

Board Of Directors
Archbishop Timothy M. Dolan, President
Archbishop Charles J. Chaput, O.F.M. Cap
Archbishop William E. Lori
Reverend Wayne C. Paysse, Executive Director

 

 

 

Office Update Form

Submission Instructions

1. This form should be filled out and submitted online only.

2. This form can be filled out anytime of the year, on an as need basis. All information must be filled out in order to submit.

 

Authorized Ordinary Digital Signature & Date

Arch/Diocese *
Digital Signature of Authorized Ordinary *
Date Signed*

 

Office Record Update Information

1. Arch/Diocese *
Ordinary *
Street Address *
City *
State *
Zip/Postal Code *
Work Phone *
Fax
Email *

 

2. Auxilary Bishops
Name
Name

 

3. Chancellor (Please indicate title - i.e., Monsignor, Father, Brother, Mr., Mrs., etc.)
Name
Street Address
City
State
Zip/Postal Code

 

4. Director/Person in charge of the Black and Indian Mission Collection at the Chancery:
Name *
Street Address *
City *
State *
Zip/Postal Code *

 

5. Name of the Diocesan Newspaper: *
Editor *
Street Address *
City *
State *
Zip/Postal Code *
Fax
Email *

 

6. Director/Coordinator of Black Ministry
Name *
Street Address *
City *
State *
Zip/Postal Code *
Fax
Email *
  Director/Coordinator of Native American Ministry
Name *
Street Address *
City *
State *
Zip/Postal Code *
Fax
Email *

 

7. Date of Black and Indian Mission Collection *

 

8. Type of Collection in your Arch/Diocese *
 Single Collection- (only for Black and Indian Mission Collection)
 Combined Collection - List other Collection(s) 1.
2.
3.
 Contribution

 

9. Promotional Materials *

The director/person in charge of the Black and Indian Mission Collection (listed in # 4 on this form) will be receiving an email from Casey Claypool of Our Sunday Visitor concerning promotional materials and envelope orders and requesting them to update the list of parishes.

If you have any questions regarding the promotional materials please contact Casey Claypool at Our Sunday Visitor by email at cclaypool@osv.com or by phone at (800) 348-2886 x2423. Promotional materials can also be found on www.blackandindianmission.org under the grants and resources tab.

Please check one of the following:

 Send promotional packets to our parishes. Do not send packets to the parishes.

 
Your Name*
Please re-type your name as your digital signature *
Your Email Address *
Date *