Virtual Workshop 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. / Por favor, proporcione su mes / día de nacimiento - ¡NO NECESITAMOS EL AÑO! Esta información se utiliza como un identificador adicional en nuestra base de datos.
Please enter valid data.
Please provide your Month/Day of Birth - NO YEAR NEEDED! It is used as an additional identifier in our database.

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Parish, City REQUIRED Please fill out this field.
If you are from Outside the Diocese of Davenport, please provide your Parish Name, City and Diocese Please enter valid data.

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My Primary Role in Ministry is: REQUIRED Please fill out this field.
If Other, Please indicate your Primary Role in Ministry Please enter valid data.

I am registering for the following Virtual Workshops: REQUIRED

80 – All Six Virtual Workshops (Includes Recording of 1/12 Workshop and remaining Live Sessions)

45 – All Morning Workshops (1/26, 2/23, 3/23 - 10AM-11:30AM)

45 – All Evening Workshops (Live Sessions 2/9, 3/9 - 7PM-8:30PM and Includes the Recording of the 1/12 Workshop)

20 – Teaching Your Students about Mass and Discipleship (1/26 - 10AM-11:30AM)

15 – Strengthening the Parish by Fostering Discipleship (2/9 - 7PM-8:30PM)

15 – Engaging Teenagers: Building a Living Faith (2/23 - 10AM-11:30AM)

15 – The Hospitable Parish (3/9 - 7PM-8:30PM)

15 – Getting Your Students (And their Parents) to Engage with Mass during this Pandemic (3/23 - 10AM-11:30AM) Please fill out this field.

Acknowledgements

Cancellation Policy
- Cancellations must be received at least 8 days prior to the workshop. Cancellations received after this time will be assessed a $10 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 $10 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 "Virtual Workshops" 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, please contact Rosina Hendrickson (563-888-4244)