DCCC Student Registration 2019-2020
Email address *
Name *
Your answer
Last Name *
Your answer
Sex *
Current School Address *
Your answer
Phone Number *
Your answer
Living Group
Student ID number (last five digits) *
Your answer
Birth Date *
Your answer
What is your major? *
Your answer
Classification
Anticipated Graduation Date? *
Graduation Year, spring/fall
I still need to receive the following sacraments:
If Baptized, were you baptized in the Catholic Church?
Are you open to a religious vocation?
High School
Name, city, and state
Your answer
Home Parish
Name, city, and state
Your answer
What is your permanent address (where you live when you're not at ESU)? *
Your answer
Father's name
Your answer
Father's email
What is the best email address where your father can be reached?
Your answer
Father's Phone Number
What is the best number at which your father can be reached?
Your answer
Mother's name
Your answer
Mother's email
What is the best address where your mother can be reached?
Your answer
Mother's Phone Number
What is the best number at which your mother can be reached (if different from your father's)?
Your answer
Is one parent's address different from your permanent address? If so, please indicate which parent, and include their address.
Your answer
Are either of your parents ESU alumni? *
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