Catholic Patriots Student Registration
About You
Full First Name
Last Name
Nickname / Other Names
Cell Phone
Email
Gender
Female
Male
Date of Birth
School
GMU
NOVA
Other (Please Describe)
School (Other):
Year
Freshman
Sophomore
Junior
Senior
Grad Student
Class Year
Graduate Class Year
Are you Catholic?
Yes
No
Religious Affiliation
Interests / Activities
Are you interested in a Small Group or Bible Study?
Yes
No
Athletic Team (if applicable)
Select your interests and we'll be in touch soon!
Intramural Sports
Community Service
Men's/Women's Ministries
Hispanic Ministry
OCIA (becoming a Catholic)
Liturgical Singer / Musician
Liturgical Minister (Lector & Usher)
Altar Server
Event 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
Please select...
Mr.
Mrs.
Ms.
Parent / Guardian First Name
Parent / Guardian Last Name
Parent / Guardian Phone
Parent / Guardian Email
Add another Parent / Guardian
Salutation
Please select...
Mr.
Mrs.
Ms.
Parent / Guardian 2 First Name
Parent / Guardian 2 Last Name
Parent / Guardian 2 Phone
Parent / Guardian 2 Email
Family Home Address
Street
City
State
Please select...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington, DC
West Virginia
Wisconsin
Wyoming
ZIP Code
Home Parish Name & Town
Contact Information