Catholic Patriots Student Registration

About You

Full First Name

Last Name

Nickname / Other Names

Cell Phone

Email

Gender

FemaleMale

Date of Birth

School

GMUNOVAOther (Please Describe)

School (Other):

Year

FreshmanSophomoreJuniorSeniorGrad Student

Class Year

Graduate Class Year

Are you Catholic?

YesNo

Religious Affiliation

Interests / Activities

Are you interested in a Small Group or Bible Study?

YesNo

Athletic Team (if applicable)

Select your interests and we'll be in touch soon!

Intramural SportsCommunity ServiceMen's/Women's MinistriesHispanic MinistryOCIA (becoming a Catholic)Liturgical Singer / MusicianLiturgical Minister (Lector & Usher)Altar ServerEvent Cooking (TNS, SNG, etc)Event Setup & Cleanup

Is there a cultural, ethnic, or language ministry you're interested in?

Share anything else you'd like us to know!

Family Information

We ask these questions so we can occasionally reach out to Catholic students' families about things going on at CCM. We never sell or share any information.

Parent / Guardian Information

To add information for additional parents/guardians, click "Add another Parent / Guardian" below.

Salutation

Parent / Guardian First Name

Parent / Guardian Last Name

Parent / Guardian Phone

Parent / Guardian Email

Add another Parent / Guardian

Salutation

Parent / Guardian 2 First Name

Parent / Guardian 2 Last Name

Parent / Guardian 2 Phone

Parent / Guardian 2 Email

Family Home Address

Street

City

State

ZIP Code

Home Parish Name & Town

Contact Information