Sick List Request Form

- Prayer Request Submissions
  Please note that prayer request names must be submitted by Wednesday to be included in our Prayer Request Book for that weekend’s Mass. Going forward, prayer request names will no longer be printed in the bulletin.
  
  We kindly ask that before submitting any name(s), you confirm that the individual wishes to be added to the sick list/prayer request list
- The maximum number of form submissions has been reached. This form is currently not available.
  
  Requesting Persons Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Numbe of Names for Sick List/Prayer Request REQUIRED
  Please use the up or down arrows to select the number of names you would like to add.
  Please fill out this field.
  
  Name for Sick List 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Reason for request REQUIRED Please fill out this field.
  
  Relationship to Person I am adding to Sick List REQUIRED Please fill out this field. Please enter valid data.
  
  I have spoken with this person I am adding to the sick list and have their permission to add their name? REQUIRED Yes No Please fill out this field.
  
  Name for Sick List 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Reason for request REQUIRED Please fill out this field.
  
  Relationship to Person I am adding to Sick List REQUIRED Please fill out this field. Please enter valid data.
  
  I have spoken with this person I am adding to the sick list and have their permission to add their name? REQUIRED Yes No Please fill out this field.
  
  Name for Sick List 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Reason for request REQUIRED Please fill out this field.
  
  Relationship to Person I am adding to Sick List REQUIRED Please fill out this field. Please enter valid data.
  
  I have spoken with this person I am adding to the sick list and have their permission to add their name? REQUIRED Yes No Please fill out this field.
  
  Name for Sick List 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Reason for request REQUIRED Please fill out this field.
  
  Relationship to Person I am adding to Sick List REQUIRED Please fill out this field. Please enter valid data.
  
  I have spoken with this person I am adding to the sick list and have their permission to add their name? REQUIRED Yes No Please fill out this field.
  
  Submit
  
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- Contact Us
  
  Deacon Pete Cornell
  
  Deacon
  
  248-347-7778
  
  Deacon Glenn Melenyk
  
  Deacon
  
  248-347-7778
  glennmelenyksjnovi.net
  
  Father Ed Zaorski
  
  Pastor
  
  248-347-7778 ext 16
  ezaorskisjnovi.net
  
  Sr. Clare Emeruom
  
  Pastoral Associate/Evangelical Charity Director
  
  248-347-7778 ext. 17
  daluclaresjnovi.net
  
  Rigonda Savickas
  
  Parish Administrator
  
  248-347-7778, ext. 10
  parishsecretarysjnovi.net

St. James

Novi, MI

Sick List Request Form

Contact Us