Called By Name Submission Form – Diocese of Scranton

Called By Name

Email

This field is for validation purposes and should be left unchanged.

Name of Submitter(Required)

First Last

Phone

Email

Address

Street Address Address Line 2 City State ZIP Code

Name of Nominee(Required)

First Last

Phone

Email

Address

Street Address Address Line 2 City State ZIP Code

Age of Nominee(Required)

If nominee is under age 18, please submit name of parent below.

Contact Information

Nominee's Parish(Required)

Nominee's Pastor

Nominee’s School (if applicable)