Confraternity of Pilgrims to Rome

Membership Form 
(please save this form to your PC and then email it to
membership@pilgrimstorome.org.uk)
 

*Surname       _____________________________________


*Names         _____________________________________


*Email         _____________________________________

Note:  the above 3 items are mandatory


Address Line 1 _____________________________________


Address Line 2 _____________________________________


Town           _____________________________________


Postcode       _____________________________________


Country        _____________________________________


Tel No.        _____________________________________


Fax No         _____________________________________


Departing/ed from __________________


Departure Date    __________________


Arrived in Rome   __________________

About Me

____________________________________________________


____________________________________________________


____________________________________________________


____________________________________________________


look forward to welcoming you as a member


William