Student Registration Form

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Your Personal Information
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Street Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Gender REQUIRED Male Female Please fill out this field.
- Home Parish REQUIRED Please fill out this field. Please enter valid data.
- Status REQUIRED Please fill out this field.
Parental Information (We send out a newsletter!)
- Parent(s) Name REQUIRED Please fill out this field. Please enter valid data.
- Parent's Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Parent's Phone REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Parent Email REQUIRED Please fill out this field. Please enter valid data.
Volunteer Opportunities
- Please select all that interest you FOCUS Bible Studies Religious Education for Children Elementary School Tutoring (Oasis) Music Ministry Diversity & Inclusion Lector/Eucharistic Minister Adoration Guardian Knights of Columbus (For Men)
Are you in Greek Life? Yes No
If so, which chapter are you in? Please enter valid data.
Are you a student athlete? Yes No
If so, which sport? Please enter valid data.
Sacramental Information
- Which Sacraments (if any) are you in need of? Baptism Confirmation I want to become Catholic! (RCIA)

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