| St. John Church and Student Center

Students please submit a new registration form each year so our information is current.
*=required

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Sex REQUIRED Please fill out this field.

Birthdate REQUIRED Please fill out this field. Please enter a date.

Marital Status

Status REQUIRED Please fill out this field.

Major REQUIRED Please fill out this field. Please enter valid data.

Start Date Please enter valid data.

Expected Graduation Date REQUIRED Please fill out this field. Please enter a date.

Address for fall semester 2020 REQUIRED Please fill out this field.

E-mail Address REQUIRED Please fill out this field. Please enter an email address.

Phone Number Please enter valid data.

Name of your home Parish Please enter valid data.

What Diocese are you from? Please enter valid data.

Did you attend Catholic School?

If yes, what school(s)? Please enter valid data.

Parent's Address: street, city and zip REQUIRED Please fill out this field.

St. John Church & Student Center