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JustFaith Registration Form

Please print out, fill in and return to the St. Charles Parish Office by August 15, 2005.
Contacting Jody Brady, 703-527-5289, or Giselle Dupuis, 703-522-0565 or justfaith@stcharleschurch.org

Name: ________________________________________________

Street Address: ________________________________________________

City: ________________________________ Zip Code: ________________

Phone numbers:

day: (_____) ________________     eve: (_____) ________________

cel: (_____) ________________     (Please indicate preferred contact number)

E-mail address: ________________________________

Please check all that apply:

_____ Yes, I'm interested in joining a JustFaith group on Monday nights.

_____ Yes, I'm interested in joining a JustFaith group-but on another night.
               Please provide two alternative nights: 1)                                   2)

_____ Yes, I'm interested in co-facilitating a JustFaith group.
            (Note: All materials for leading will be provided well in advance, and the JustFaith office will support all groups.)

_____ If available, I am interested in a young adults JustFaith group.

_____ I would like to receive information about JustFaith scholarships.