JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
2013 March for Life Registration
St. Paul's Church Pro-Life Committee
Harvard University Catholic Center & Chaplaincy
WELCOME TO OUR GROUP
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Name
*
(Last, First)
Your answer
Driving to St. Paul's and need parking?
*
If you select YES, there is parking available at St. John the Evangelist Church in Cambridge; we will send you details
No
Yes
What is your mobile number?
*
This number will be kept confidential; please note that we will be using text messaging in Washington DC to distribute important updates
Your answer
What is your e-mail address?
*
This address will be kept confidential
Your answer
Please list emergency contact(s)
*
For your benefit, we ask that you please provide us with the full name, mobile number, and e-mail for each contact listed
Your answer
Please select your bus ticket option
*
$40 - Adult/Professional
$30 - Student/Senior/Child
$00 - Priest/Religious/Seminarian
Please select your payment method
*
Make all checks and money orders payable to the Saint Paul's Church Pro-Life Committee, 29 Mount Auburn Street, Cambridge, MA 02138
Online using the PayPal Account
Exempt - priest/religious/seminarian
Check or cash mailed to 29 Mount Auburn Street
Check or cash in drop box by front desk at 29 Mount Auburn Street entrance
Would you like to subscribe to our e-mail list?
*
This list helps us to keep in touch and promote upcoming events
Yes
No
Already subscribed
Your questions and concerns are important to us; if needed, please use the box below. See you soon!
Please direct additional inquiries to
SaintPaulLife@gmail.com
- thank you
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report