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* 1. Location Information & Contact Info

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* 2. Which Weeks would you be interested in a Visitation? Check all that apply. The more weeks you check increase the chance of having a visitation.)

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* 3. Time of Day Requested (Check All that apply/Would work)

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* 4. Type of Visitation or Event with the Missionary Image of Our Lady of Guadalupe  (Check All Potential Events Interested In)

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* 5. Do you have contacts at any of the following potential visitation sites that you would be willing to share with us?

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* 6. Feel free to let us know below of any ideas or suggestions you have regarding the October visitation of the Missionary Image of Our Lady of Guadalupe.

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