Course Registration

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

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

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.

Contact Information - Please provide at least ONE Phone Number and E-mail Address

Cell Phone Number Please enter a phone number.
Home Phone Number Please enter a phone number.
Work Phone Number Please enter a phone number.
Email REQUIRED Please fill out this field. Please enter an email address.

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Month/Day of Birth
Please provide your Month/Day of Birth - NO YEAR Needed - This is used as an additional identifier in our database
Please enter valid data.
Please provide your Month/Day of Birth - NO YEAR NEEDED! It is used as an additional identifier in our database.

Ministry Information

If you are from the Diocese of Davenport, please complete the following questions:

Please briefly indicate your reasons for registering for these courses
Please briefly explain how these courses will assist you in your ministry area

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I am interested in pursuing .... REQUIRED The Certificate in Lifelong Faith Formation The Certificate in Youth Ministry Studies Individual Courses Please fill out this field.
I am interested in receiving information on obtaining undergraduate/graduate credit for these courses REQUIRED Yes No Please fill out this field.
I am registering for the following course: REQUIRED Justice and Service (December 7-8, 2019) Please fill out this field.

Please indicate any dietary restrictions

Cancellation Policy

Cancellations must be received at least 30 days prior to the course. Cancellations received after this time will be assessed a $50 cancellation fee.

I have read and understand the Cancellation Policy Please select this field.

No Show Policy

No Shows will not be reimbursed for payments received and if unpaid, will be assessed a $50 no-show fee.

I have read and understand the No Show Policy Please select this field.

Payment type:
Credit Card or echeck (electronic check) please select "Pay Now"
OR
Check by US Mail please select "Pay Later"

US MAIL- If you are paying by US mail please send payment to:
Check and Money Order payments are payable to Diocese of Davenport. Please indicate "Certificate in Ministry Studies" in the Memo Line.

Mail to:
Diocese of Davenport
Office of Faith Formation
780 W. Central Park Avenue
Davenport, IA 52804-1901

If you need an additional invoice or have any questions regarding the Certificate in Ministry Studies, please contact Rosina Hendrickson (563-888-4244) at your convenience.

Non-Refundable Registration Fee50.0

Diocese of Davenport

Davenport, IA

Course Registration

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Registration for Certificate in Ministry Studies Courses