St. John Vianney Church
CCD Registration
Advocate Information
First Name:
Last Name:
Address 1:
Address 2:
City:
State:
MD
VA
Zip Code:
Home Phone:
(10 numeric digits)
Cell Phone:
E-mail:
Re-enter Email:
Grade in school:
9
10
11
12
Notes:
Please check your information before submitting.