Basilica of the National Shrine of the Immaculate Conception Usher Application

Full Name

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Mobile Phone

Daytime Phone

Other Phone

Email Address

Member Number

Council Name

Council Number

Council Location

Why do you wish to serve as a Knight at the Basilica?

For each week of the month, select your preference for serving at Mass during that week. If you cannot serve during that week of the month, select the Cannot Serve option.

Week One

Week Two

Week Three

Week Four

Week Five

For each Mass time, select your preference for serving at Mass during that time. If you cannot serve during that time, select the Cannot Serve option.

Saturday 4:30 PM

Sunday 7:30 AM

Sunday 9:00 AM

Sunday 10:30 AM

Sunday 12:00 PM

Sunday 2:30 PM

Sunday 4:30 PM

In addition to a regular assignment, service opportunities at other times for special pilgrimages and events is available. These could be scheduled on weekdays or weekends during the day or evening. Are you available to serve at these occasions?

Which languages do you speak and understand?

Date