Roman Catholic Diocese of Erie - Acceptiva

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

Quo Vadis Days

July 30 - August 2, 2023

St. Mark Seminary in Erie, PA

***Deadline to Register: July 21, 2023***

Qty

Description

Amount

Total

Registration Fee - Quo Vadis Days

$50.00

$50.00

(per participant)

Total: $50.00

Student Information

Student Name: *

First and Last

Student Address: *

City: *

State: *

Zip Code: *

Home Phone:

Cell Phone: *

Birthdate: *

Email: *

School: *

Grade in the Fall of 2023: *

Parish and City: *

Adult T-Shirt Size: *

Food Allergies or Dietary Restrictions:

Parent Information

Parent/Guardian Name(s): *

Parent Email: *

Payer Information

First Name: *

Last Name: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Telephone:

Email: *

A receipt will be emailed to this address.

Comments or Questions:

Your Payment Information

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *

Name on Account: *

Routing Number: *

Account Number: *