Clergy Registration - Life Teen Steubenville Conferences

Clergy Registration Form

Name*
Prefix First Last
Registration Type*
- Priest
- Deacon
Steubenville Location*
- Lone Star
- Florida
- Atlanta
- West
- East
- San Diego
Diocese*
Order (if applicable)
Parish Name*
Parish City & State*
City State
Email*
Parish Phone*
Cell Phone*
Would you like a secretary, assistant, or youth minister to be copied on correspondence with you regarding the conference?*
Name of secretary/assistant/youth minister*
First Last
Email address of secretary/assistant/youth minister*
Are you coming with a registered parish group?*
Group Leader Name*
First Last
Group Parish Name*
Group City & State*
City State
Will you be attending for the full weekend?*
Please tell us anything else we should know about your attendance at the conference.
Email
This field is for validation purposes and should be left unchanged.