Monthly Pamphlet Program

This form is to add Parishes to the Monthly Pamphlet Program.

Salesperson Information
Provide your information
Sales Representative Name
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Sales ID Number
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CSR
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Email
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Commissionable
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Sales/Customer Service Phone -- ext
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What number would you like to be called on if there is a question about this order?
Parish Information
Account Number
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Church Name
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Physical Church Address
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Shipping Address
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If shipping address is the same as physical address, click Yes
Shipping Address
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Parish Phone Number --
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Contact Name
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Questions pertaining to this order at the parish
Contact Phone if different than the parish number --
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Parish Contact's E-mail
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Comments
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Pamphlets
Select the quantity of pamphlets that will ship automatically each month. Helpful tips: To determine the appropriate quantity needed for your parish, consider how many bulletins, families, or other bulk items you purchase.
Monthly Quantity
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