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Registration form
Register with the Sacred Heart of Jesus Catholic Student Center and Catholic Student Association at the University of South Alabama and gain 24/7 access to our Church.
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* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Gender
*
Male
Female
Phone Number
*
Your answer
What university do you attend?
*
USA
Springhill College
University of Mobile
Other:
Email Address (must be
Jagmail
for USA students)
*
Your answer
Jag Number (Student ID if you are a student at another university)
*
J00******
Your answer
Year
*
Freshman
Sophomore
Junior
Senior
Graduate
Expected Graduation Date
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Major/Program of Study
*
Your answer
Are you Catholic?
*
Yes
No
Have you been confirmed?
*
Yes
No
No, I'm not Catholic.
If not Catholic, what denomination?
Your answer
What is your home parish? (Parish, City, State)
Your answer
Dorm Name
Your answer
USA Box Number
Your answer
Apartment Complex
Your answer
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