Cells of the Society - Payment Step 1

Please print out and return this form to The Membership Secretary, Mileham House, 6 Common Place, Walsingham, Norfolk NR22 6BW

We, being members of the Society of the Holy House of Our Lady of Walsingham, together with the duly nominated first Superior named below, request the setting-up of a Cell of the Society, to be named:

The Cell of the Society of the Holy House of Our Lady of Walsingham and Saint(s):

(Please enter names)

The Cell will be based in the Parish of

Or the church/school of

In the Diocese of

We nominate as the first superior
(Priest Associate of the Holy House)

Where the person nominated is not the incumbent or head of the institution named above:

With the permission of:

Name and Office

We appoint a Cell Secretary:

Name

Address

Signature

Telephone

Email:

Names (in BLOCK CAPITALS) and signatures of 7 Founder Members:

Name

Signature

Signature: Nominated First Superior

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