Registration:Young Neighbors in Action
2017 Mission Experience

Please complete a separate registration for each child.

Participant First & Last Name *
Your answer
Parent First & Last Name *
Your answer
Participant Email (if none, write NONE)
Your answer
Parent Email (if none, write NONE)
Your answer
Participant Phone Number
Your answer
Parent Phone Number *
Your answer
Address: *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Participant High School Graduation year *
Would you like to sign up for the 2017 Young Neighbors Mission Experience? *
Down payment:
Please note that registration becomes official upon receipt of $50 down payment. Make check payable to St. Mary and add YNIA in the Notation space. Payment can be dropped off in person or mailed to:

St. Mary Catholic Faith Community
Attn: Jeff Kacala
9520 W. Forest Home Ave.
Hales Corners, WI. 53130

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