GMU CCM Long Card Registration
First Name *
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Last Name *
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Date of Birth
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Gender
Cell Phone
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Email
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School
Year
Class of
Housing
Residence Hall
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Are you Catholic? *
If not, what is your religious affiliation?
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Are you interested in Bible Study/Small Group? *
Greek Chapter (if applicable)
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Athletic Team (if applicable)
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Home/Permanent Street Address
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City
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State
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Zip Code
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Parent/Guardian Name(s):
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Home Parish Name & Town
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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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