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Registration - Permanent Community Member
For the 2019-2020 School Year
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* Indicates required question
Name
*
Your answer
Address
*
Your answer
Email
*
Your answer
Birth date
MM
/
DD
/
YYYY
Gender
Your answer
Phone (Home)
Your answer
Phone (Cell)
Your answer
University Status
Check all that apply
Faculty
Staff
No UToledo status
University Department and Address
Your answer
UToledo Alumni Year:
Your answer
Degree(s) / Majors (s):
Your answer
Children (18 years or under), Name / Gender / Birth date:
Your answer
Occupation, previous occupations or special interests:
This information will be used for possible mentoring or connections with students and if Fr. Jeremy needs a consultant in a particular area.
Your answer
Are you registered with any other parish in the Diocese of Toledo?
Yes
No
Clear selection
If so, where?
Your answer
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