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Registration Form

Thank you for tking the time to complete this online registration form for you and your family.  Please contact Heidi Schwank with any questions regarding this process at 608-752-8708.



    • Name *


    • Date of Birth *

    • Sacraments Received *




    • Occupation *

    • Spouse Name


    • Date of Birth

    • Occupation

    • Sacrament Received




    • Address *







    • Phone Number *



    • Email *

    • Child #1 Name


    • Date of Birth

    • School Attending

    • Sacraments Received



    • Child #2 Name


    • Date of Birth

    • School Attending

    • Sacraments Received



    • Child #3 Name


    • Date of Birth

    • School Attending

    • Sacraments Received



    • Child #4 Name


    • Date

    • School Attending

    • Sacraments Received




Authentication Text*
(Enter the text in the image above into this field.)

NOTE: Do Not Alter These Fields: