The Membership of the Missionaries of Mercy Please print, complete, and mail this form to: SOLT Office of the Laity PO Box 417 Bosque NM 87006-9708 NAME: First: _____________________________________   Last: ______________________________________ ADDRESS: Street: ________________________________________________________________________________ City: _____________________________________   State/Zip or County: ___________________________ Country: ______________________________________________________________________________ Email: ________________________________________________________________________________ PARISH & DIOCESAN AFFILIATION: Name(s): _____________________________________________________________________________ DATE: ________________________________________________________________________________ SIGNATURE: ___________________________________________________________________________