Holy Face of Jesus Items Order Form

Please tick the items that you would like to obtain

Fields marked * are mandatory

* Please send me

Blessed Holy Face A4 image
Blessed Holy Face of Jesus medal
Holy Face booklet of prayers

* Please send me :: Please select at least one

* Donation towards HLI (Ireland) projects

* Donation towards HLI (Ireland) projects :: Please enter amount in figures and currency

* Method of Payment

Cheque
Postal Order
Draft/money order
Credit/laser card
Other

All cheques/POs/drafts to be made payable to Human Life International (Ireland). Thank you

* Name

* Address

* Address :: Please enter your full postal address

* Email

Telephone

Message

* Add me to postal mailing list?

Yes
No
Already on

* Add me to email list?

Yes
No

Please ensure that you have filled in the mandatory fields