GMU CCM Long Card Registration
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First Name *
Last Name *
Date of Birth
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DD
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Gender
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Cell Phone
Email
School
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Year
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Class of
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Housing
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Residence Hall
Are you Catholic? *
If not, what is your religious affiliation?
Are you interested in Bible Study/Small Group? *
Greek Chapter (if applicable)
Athletic Team (if applicable)
Home/Permanent Street Address
City
State
Zip Code
Parent/Guardian Name(s):
Home Parish Name & Town
Check anything you're interested in below, we'll be in touch with you soon about how to get involved!
Notes
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