Archdiocese of Philadelphia

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

We look forward to seeing you at the Parish Life in an Apostolic Age workshop. Please use the form below to register for the event.

Be sure to click through all the way through to the "Your Transaction is Complete" page. You will receive an email receipt confirming your registration.

In Christ, The Staff of the Office for the New Evangelization

Registration Quantity and Amount

Select the number of registrations that you are purchasing using the QTY (Quantity) box below, then click "Calculate Total." Be sure to choose which workshop date and location you are attending.

Qty

Description

Amount

Total

$15.00

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Total: $0.00

Registrant 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: *

Phone:

E-mail: *

A receipt will be e-mailed to this address.

Parish:

Parish City:

Are you a trainer?

Check this box if you are attending this workshop to be trained to give this workshop back at your parish. (Pastor permission required.)

Special Needs:

Additional Registrants

Registering more than one person? Please list the first and last name of each additional person you are registering using the "Add More Attendees" button below. Email address is optional.

(Be sure you have also selected the correct amount of registrations in the Registration Quantity box above.)

Your Payment Information

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *

Name on Account: *

Routing Number: *

Account Number: *