Roman Catholic Diocese of Lafayette (Louisiana)

Parish Affiliation

Select which church parish you attend from the drop-down menu below.

Affiliated Church Parish: *

Please select your Church Parish or choose Diocese of Lafayette if none

Donor Information

Title

Mr. Mrs. Dr. etc.

First Name: *

Last Name: *

Billing Address: *

The address that appears on your credit card statement.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Preferred Telephone: *

Preferred E-mail: *

A receipt will be e-mailed to this address.

Donor Record No.: *

PLEASE NOTE:
• This is not the same as your church envelope number or Church Parish ID.
• Your Donor Record Number is located on the pledge slip included with your letter, near the address line; it contains only numbers, no letters.
• If Donor Record Number is unknown, please enter 000.

Prayer Intentions:

Your Payment Information

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *