Roman Catholic Diocese of Erie

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

Congratulations on your engagement! We are looking forward to getting to know you during the Mentor-Cohort retreat. Thank you for filling out the registration below. Once we receive your registration, we will be in touch in the coming days to schedule a 15-minute video interview. Know of our prayers for you, and our very best wishes as you continue your journey together.

Pay Online

Qty

Description

Amount

Total

February 2023 Cohort

$50.00

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Pay it forward – donate towards a scholarship!

$50.00

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Pay by Check

Qty

Description

February 2023 cohort - $50

Please calculate your total and send check to:
Marriage and Family Life Office
429 E. Grandview Blvd.
Erie, PA
16504

Total: $0.00

Bride's Information

Bride First Name: *

Bride Last Name: *

Bride Email: *

Bride Address: *

Bride City: *

Bride State: *

Bride Zip: *

Bride Age: *

Bride Phone #: *

Bride Religious Affiliation: *

Please enter Other if selected:

Is this the bride's first marriage: *

Children for the bride? *

If Yes, Ages of Children

Groom's Information

Groom First Name: *

Groom Last Name: *

Groom Email: *

Groom Address: *

Groom City: *

Groom State: *

Groom Zip: *

Groom Age: *

Groom Phone #: *

Groom Religious Affiliation: *

Please enter Other if selected:

Is this the groom's first marriage? *

Children for the groom? *

If Yes, Ages of Children:

Additional Information

Preferred address for packages: *

Wedding Date: *

Wedding Church:

Wedding Priest/Minister:

Marriage Address:

(Address after marriage, if known)

Marriage City:

Marriage State:

Marriage Zip:

Name of a person who can contact you after marriage *

Phone number of a person who can contact you after marriage: *

We are committed to

Attending all sessions

Watching the assigned videos and discussing them as a couple

Making a good-faith effort to complete the weekly couple challenge

Participating in the cohort discussions authentically and responsibly

If you did not check all of the options above, what obstacles do you have to committing?

Answer:

Best way(s) to reach you?
You may select more than one

Call bride

Call groom

Text bride

Text groom

Email bride

Email groom

Email bride and groom together

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 e-mailed to this address.

Your Payment Information

Name on Card:

Card Number:

Security Code:

Expiration Date:

Name on Account:

Routing Number:

Account Number: