| Date of Death | Request Received | Prayer List Request | Read Aloud at Sunday Mass | First (Sick/Deceased’s Name) | Last (Sick/Deceased’s Name) | Phonetic Spelling | Parishioner? | Street Address (Address) | Address Line 2 (Address) | City (Address) | State / Province (Address) | ZIP / Postal Code (Address) | Phone | Hospital/Nursing Home Facility | Hospital/Nursing Home Facility Phone | Illness or Injury | Special Notes | Room/Bed | First (Caller’s Name) | Last (Caller’s Name) | Caller’s Relationship to “Name” | Caller's Email | Other Relationship | Caller's Phone | Caller's Preferred Contact Method | Street Address (Address) | Address Line 2 (Address) | State / Province (Address) | ZIP / Postal Code (Address) | City (Address) | Parishioner? | By completing this form, I am affirming I am a family member or have the permission of a family member. () | Entry Date |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Online Form Submission | Sick | Family | Of Malle | No | Prayers for my Families' dentist disorders. Not too peculiar to say, but they have not been able to go to dental office. | Select One | April 9, 2021 | ||||||||||||||||||||||||||
| 04/15/2016 | Online Form Submission | Died | Yes | Roberto (Berto) | Diaz | RO BARE TO (BARE TO) | Yes | 2290 Sunset Drive | Inverness | IL 60067 | (847) 922-0195 | fatal Motorcycle accident in Romulus Michigan | Fremd Graduate, Kettering University Graduate - BS In Mechanical Engineering, Masters degree studies at University of Michigan | Laura | Diaz | Son | Email hidden; Javascript is required. | (847) 922-0195 | 2290 Sunset Drive | IL 60067 | Inverness | Yes | April 16, 2016 | ||||||||||
| Sick | Yes | Yes | Select One | Phone | February 26, 2016 | ||||||||||||||||||||||||||||
| 01/02/2016 | Died | Yes | William Liesse | Brother of Pat Kubera (parishoner) | lease | No | 1520 West Barker Ave | Peoria | IL 61606 | Pat Kubera | Sister | Email hidden; Javascript is required. | (847) 991-2942 | 1567 Balmoral Drive | IL | Inverness | Yes | January 27, 2016 | |||||||||||||||
| Sick | Yes | Santa | Claus | No | 1 Candy cane Drive | North Pole | (624) 747-8627 | not in Hospital | This is a test!!!!!!!!!!!!!!!!!!!!!! He is very stressed out because there about a month to Christmas and he has a lot to do and he has a cold. | Mrs. | Claus | Other | Wife | Same as Santa | No | November 14, 2015 | |||||||||||||||||
| Sick | Yes | Select One | November 14, 2015 | ||||||||||||||||||||||||||||||
| Date of Death | Request Received | Prayer List Request | Read Aloud at Sunday Mass | First (Sick/Deceased’s Name) | Last (Sick/Deceased’s Name) | Phonetic Spelling | Parishioner? | Street Address (Address) | Address Line 2 (Address) | City (Address) | State / Province (Address) | ZIP / Postal Code (Address) | Phone | Hospital/Nursing Home Facility | Hospital/Nursing Home Facility Phone | Illness or Injury | Special Notes | Room/Bed | First (Caller’s Name) | Last (Caller’s Name) | Caller’s Relationship to “Name” | Caller's Email | Other Relationship | Caller's Phone | Caller's Preferred Contact Method | Street Address (Address) | Address Line 2 (Address) | State / Province (Address) | ZIP / Postal Code (Address) | City (Address) | Parishioner? | By completing this form, I am affirming I am a family member or have the permission of a family member. () | Entry Date |