Registration - Permanent Community Member
For the 2019-2020 School Year
Name *
Your answer
Address *
Your answer
Email *
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Birth date
MM
/
DD
/
YYYY
Gender
Your answer
Phone (Home)
Your answer
Phone (Cell)
Your answer
University Status
Check all that apply
University Department and Address
Your answer
UToledo Alumni Year:
Your answer
Degree(s) / Majors (s):
Your answer
Children (18 years or under), Name / Gender / Birth date:
Your answer
Occupation, previous occupations or special interests:
This information will be used for possible mentoring or connections with students and if Fr. Jeremy needs a consultant in a particular area.
Your answer
Are you registered with any other parish in the Diocese of Toledo?
If so, where?
Your answer
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