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General Information

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

Last Name REQUIRED Please fill out this field. Please enter valid data.
Male or Female Male Female
Birth Date REQUIRED Please fill out this field. Please enter a date.
Street Address REQUIRED Please fill out this field. Please enter valid data.
City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.
Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Email REQUIRED Please fill out this field. Please enter an email address.
Church Parish/Town REQUIRED Please fill out this field. Please enter valid data.

How did you hear about the Discipleship Team? REQUIRED Parish priest or youth minister Bulletin at a Diocesan Youth Event Catholic Free Press Social Media From a current Discipleship Team Member (Tell us below who invited you!) Other Please fill out this field.

Other comments or name of the Discipleship Team Member who invited you

What is your role in your parish? (youth minister, DRE, priest, deacon, small group leader, core team member, parent volunteer, etc.) REQUIRED Youth Minister DRE Priest Deacon Small Group Leader Core Team Member Parent Volunteer Other Please fill out this field.

If other, please explain

What does Youth Ministry look like in your parish right now? REQUIRED active youth ministry program In the process of starting youth ministry Once active but no longer no youth ministry and looking to start a program other Please fill out this field.

Comments?

Why are you signing up for the Discipleship Team? What do you hope to get out of this program? REQUIRED Please fill out this field.