Signature:_______________________________________ Print name:______________________________________ Diocese:_________________________________________ Parish:__________________________________________ Home phone:______________________________________(Note: All are welcome to sign. If you were a deputy/alternate in 1994 and/or will be a deputy/alternate in 1997, please identify that information.)
Deputy status 1994:______________________________ Deputy status 1997:______________________________Print this form, fill in the information, sign it, and mail to:
Louie Crew
377 S. Harrison Street, #12D, East Orange, NJ 07018
No cyber signings will be accepted. Sorry.
(Louie Crew is a lay deputy from the Diocese of Newark.)