Roncalli Newman Parish Student Registration
First Name *
Your answer
Last Name *
Your answer
Student Email Address (@uwlax.edu or @westerntc.edu)
Your answer
Personal Email Address
Your answer
Phone (XXX-XXX-XXXX)
Your answer
School
Do you live in the dorms?
What year in school are you? *
Anticipated Graduation Year *
Your answer
Birth Date
MM
/
DD
/
YYYY
What is your religion?
Your answer
Parent's Names
Your answer
Parent's Address (# and Street, City, State, Zip)
Your answer
Major
Your answer
Worship Interests
Yes
Greeter/Usher
Reader
Eucharistic Minister
Altar Server
Musician
Decorate the Chapel
Education/Spiritual Growth Interests
Yes
Becoming Catholic
Getting Confirmed as a Catholic
Newman Student Retreat
Participate in a Bible Study
Meet with a Priest about Religious Vocation
Service/Social Justice/Other Interests
Yes
Serve Supper at Salvation Army
Serve at the Warming Center
Teach Religious Education
Work with Youth Ministry Program
Babysit for a Parish Family
Student Leadership Opportunities
Yes
Planning Social Events
Planning Service Events
Any other interests/suggestions/questions?
Your answer
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