North Dakota
K of C Foundation

Death Memorial Card

- A perpetual Mass will be said each week for your loved one(s).
- Memorial Card Donation
  
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  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Donation Fund REQUIRED Please fill out this field.
  
  Donation Amount REQUIRED $ Please fill out this field. Please enter a positive decimal.
  
  In Memory Of REQUIRED Please fill out this field. Please enter valid data.
  
  Send Memorial Card REQUIRED Yes No Please fill out this field.
  
  Send Death Memorial Card To
  
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