National Shrine of The Divine Mercy

2 Prospect Hill Road
Eden Hill
Stockbridge, MA 01262

413-298-3931

Divine Mercy Weekend Bus Registration

Group or Parish Name:

Number of people anticipated on each bus:

Number of busses:

Primary language(s) spoken by your group:

Which days will you be attending?

Saturday

Sunday

Both

Total:

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Card Number:

Expiration Date

Security Code

what is this?

Title

*First

*Last Name

Suffix

*Address

*City/Town

*State/Province

*Zip/Postal Code

*Country

*Email

*Daytime Phone