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NCYC Group Size form

- Faith Formation

The deadline to submit this form is April 28, 2021.
The maximum number of form submissions has been reached. This form is currently not available.
- Parish/Cluster REQUIRED Please fill out this field. Please enter valid data.
- Parish/Cluster Town REQUIRED Please fill out this field. Please enter valid data.
- Group Leader Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Daytime Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Billing Information
  
  Billing 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.
  
  By default, invoicing will be sent via email to the Group Leader. Provide contact information below if billing needs to be directed to someone other than the Group Leader.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Billing contact Email Please enter an email address.
- Group size
  
  Number of Youth REQUIRED Please fill out this field. Please enter an integer (number).
  
  Number of Adults REQUIRED Please fill out this field. Please enter an integer (number).
  
  Total Number REQUIRED Please fill out this field. Please enter an integer (number).
- Notes:
- I understand that my parish will be financially responsible for the submitted participants numbers and that all fees are nonrefundable. . Please select this field.
Submit

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Diocese of Davenport

Davenport, IA

NCYC Group Size form