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
Your answer
Your answer
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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