2019-2020 Student Parishioner Registration Form

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Each year, we ask students to register (and re-register!) as members of the University Parish Newman Center to help us serve you better!

Thank you for your presence and participation in the life of your parish community!

If you have questions about this form, please contact Veronica Victoria at vvictori@kent.edu

PERSONAL INFORMATION

First Name *

Last Name *

Phone Number

Text Messaging

Yes

Clear selection

Email *

Class of

Year

Major

Birthdate

MM/DD/YYYY

YYYY

Gender

Female

Male

Prefer not to say

Clear selection

Do you live:

in a residence hall?

in an off-campus apartment?

and commute from home?

Clear selection

WHERE ARE YOU FROM?

Tell us a little about your hometown and your family.

Permanent Street Address

City

State

Zip Code

Parent(s) Name(s)

Parent(s) Phone

Parent(s) Email

GET INVOLVED!

Check the following option that best describes your sacramental status:

I am a fully-initiated member of the Roman Catholic Church. I have received the Sacraments of Baptism, Confirmation and Eucharist in the Roman Catholic Church.

I have been baptized Roman Catholic, but I am in need of the Sacrament of Confirmation

I have been baptized Roman Catholic, but I am in need of Eucharist and Confirmation.

I am not Roman Catholic, but I am interested in becoming Catholic through the Rite of Christian Initiation of Adults (RCIA).

I am not Roman Catholic.

Clear selection

What are your interests? (check all that apply)

Ministry at Mass

Retreats

Prayer & Faith Sharing Groups

Social Events

Service/Social Justice

Service Trips

Music Ministry

Intramurals

CCD/PSR Teacher

Youth Ministry Team

Other:

Submit

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