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of PagesST.
LEO THE GREAT CATHOLIC CHURCH COLUMBARIUMDATE: ________________________
NAME
____________________________________________________________________________________LAST FIRST MIDDLE INITIAL
ADDRESS________________________________________________________________________________
_________________________________________________________________________________________ NUMBER
City
State
Zip
Telephone
PAYMENT SCHEDULE:
□
PAID IN FULL $_________________________□
DEPOSIT OF $ __________ WITH MONTHLY PAYMENTS OF $____________FOR ONE YEAR□
OTHER:___________________________________________________________________________NICHES WILL BE ASSIGNED ON A FIRST COME FIRST SERVED BASIS.