Please complete this form and submit to the Mercy Center. You may also print this form and mail to the Mercy Center, 1322 East Northern Parkway, Baltimore, Maryland 21239. Please mark envelope in care of Kathleen Tallent.
First & Last Name
Date (m/d/y)
Home Phone
Work Phone
Street Address
City
State Zip Code
Date of Birth
Religious Affiliation
Marital Status Single Divorced Widowed Married
If married spouse's first name
Place of Employment
Present Occupation/Vocation
Previous Employment or other work skills
Educational Experiences
How long have you known the Mercy community and how are you acquainted with the Sisters of Mercy?
What led you to respond to the invitation to become a Mercy Associate?
Why do you want to be more closely associated with the Sisters of Mercy and other Mercy Associates?
Specifically and practically, in what ways do you hope to participate in the life and mission of the Sisters of Mercy?
Regional Community of Baltimore
1322 E. Northern Parkway
Baltimore, MD 21239-1998
Phone: 410-435-4400
Fax: 410-433-8868
email: webmaster
