CCW New Member Registration
Tell us about yourself! Once you complete the form, a member will be in contact with you. We look forward to welcoming you into the fold!
Sign in to Google to save your progress. Learn more
Email *
Full Name *
Nickame?
Address *
Phone Number *
Email *
Birthday (Month and Day) *
I need a ride to/from gatherings
Clear selection
I can provide transportation for someone to/from gatherings
Hobbies or Interests?
Are you a professional or volunteer with any community agencies with which our affiliate should collaborate?
Are you a speaker on any topic?
Join a Committee!
I'd love to!
Help set up meetings/Coordinate Food Sign Ups
Help plan service projects
Plan Meeting Topics/Calendar
Plan Days of Reflection or Retreats/Spirituality Activites
Help with membership promotion
Start a Committee! 

Do you have a passion you'd like to share and invite others to join? Tell us about it!
Dues are $20 Annually. Your dues help us maintain our affiliation with the Deanery, Diocesan and National Councils, allow us to provide materials and refreshments for monthly gatherings, support HUGS FOR THE HOMELESS Florida Council Campaign, and sponsor parish-affiliated events and programs. 
Check/Cash: Make out Check to San Juan del Rio. Put "CCW" in Memo Line. Can be paid to any CCW Officer at an upcoming gathering or dropped at Parish Office.
Online: https://sjdr-ccw.ticketleap.com/annual-dues-2022-23/https://sjdr-ccw.ticketleap.com/annual-dues-2022-23/
**Please state how you will pay below**
*
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy