Catholic Campus Ministries/Register/Pensacola, FL

Type of Registration REQUIRED

New Member: Have never been to CCM before. This will include transfer students and freshmen. Renewing Membership: Returning students to update their information.

New CCM Member Renewing CCM Membership Please fill out this field.

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

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

Gender REQUIRED Male Female Please fill out this field.

Email REQUIRED Please fill out this field. Please enter an email address.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Date of Birth REQUIRED Please fill out this field. Please enter a date.

Shirt Size REQUIRED

New students will receive an official CCM T-Shirt.

Please fill out this field.

First Year on Campus? REQUIRED Yes No Please fill out this field.

Are you living on Campus REQUIRED Yes No Please fill out this field.

If so, what dorm? REQUIRED Please fill out this field.

Anticipated Graduation Date REQUIRED Please fill out this field. Please enter a date.

School REQUIRED University of West Florida Pensacola State College College-Age Please fill out this field.

School Identification Number REQUIRED Please fill out this field. Please enter valid data.

What is your major? Please enter valid data.

Are you interested in helping at the 4:30 pm Student Mass? REQUIRED Yes No Please fill out this field.

If so, how would you like to help? (check all that apply). REQUIRED Lector Altar Server Extraordinary minister of Holy Communion (upperclassmen only) Sacristan Usher (greeting people, helping with the collection). Music N/A Please fill out this field.

What parish did you attend (home parish) prior to arriving at UWF/PSC? REQUIRED Please fill out this field. Please enter valid data.

Father's Name REQUIRED Please fill out this field. Please enter valid data.

Mother's Name REQUIRED Please fill out this field. Please enter valid data.

Parent(s) Mailing 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.

This address is for ... REQUIRED Father Mother Both Please fill out this field.

Can we contact your parents? REQUIRED

We will contact your parents and/or send them a newsletter to share with them all the great things that CCM is doing.

Yes No Please fill out this field.

You will be added to our newsletter mailing list.

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2022-2023 REGISTRATION

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