PilgrimageRequestForm

The National Shrine of Our Lady of Lebanon
Pilgrimage Request

Your Name

Today's Date:

Name of Your Group

How Many In Your Group:

Your Address:

Fax #

Phone #

Time of Arrival

Time of Departure

Date of Your Group's Visit:

Group Leader

Arriving By Bus or Private Vehicles

Click Here To Fill Out Menu Options Form

Will you need the services of the Shrine Rector?	Yes No
Divine Liturgy?	Yes No
If Yes,	With Your Own Priest? With The Shrine Rector Only? With Both Priests?
Exposition of the Blessed Sacrament?	Yes No
Confession?	Yes No
If Yes,	With Your Own Priest? With The Shrine Rector Only? With Both Priests?
Rosary? (Self Lead)	Yes No
Outdoor Stations of the Cross?	Yes No
Martyrs Trail?	Yes No
If Yes,	Self Tour? (30 min) Wagon Ride? (Availability Limited)
Shrine Informational Video? (30 Min)	Yes No
Conference(s) and/or Spiritual Talks?	Yes No
Please List Desired Topics:
Free Time for Your Own Program?	Yes No
If Yes, Est Time Needed:

INSTRUCTIONS
Please Fill Out Form, Click "Print me" and mail to the:
National Shrine of Our Lady of Lebanon
2759 North Lipkey Rd
North Jackson, Ohio 44451
(Phone # 330-538-3351)