Electronic Registration Form
College Connection Program
 

    

You may fill out the following electronic form to submit the names of high school students who are graduating and who will be entering college.  The results of the form will be sent to Msgr. James Bartylla, Director of Vocations.  If you have any difficulties completing this form, please send an email to the Office of Vocations Web Coordinator.

In accordance with the policy of both Serra International USA Council and the Catholic Campus Ministry Association, information furnished by use of this form shall not be given to anyone other than to the Campus Minister and staff, for the sole purpose of inviting students to visit their facility when they arrive on campus. Students not wishing to receive such a letter should not include their home address.

What is the student's name?
What parish does the student attend most regularly?
Parish Name
 
City
What is the student's home address?
Address, Line 1

Address, Line 2 (if needed)
       
City                                                 State     Zip
What is the name of the college
that the student will be attending?
What city and state is the college located in?  
City                                                 State
May we have your email address in case
we need to contact you about your submission?

When you've finished the form,
please click on the submit button below
 to send the form to the Office of Vocations.