Diocese of Madison
Lay Institute Level I (2006-07)
Additional Participant Information

Complete the entire form and then click the 'Submit' button at the bottom of the page.
Do not use the 'Enter' key.

Each registered participant is asked to complete and submit this online form.
If you have questions, please call 608-821-3160 or send e-mail to OEC@straphael.org.


First Name:
Last Name:
Gender: Male      Female
Birthdate:
Status: single    married    widowed    divorced or separated    consecrated single    vowed religious    ordained
Occupation:
How long have you lived in the Diocese of Madison?

List any course dates for which you know you have scheduling conflicts.



Church Involvement
Current Home Parish:
City where home parish is located:
How long have you been a member of this parish?

If you have been a member of the above parish for less than two years...
Previous home parish:
City where previous parish was located:
How long were you a member of that parish?

What types of service have you been involved with in your parish in the past three years?


List any Catholic orders, movements, organizations or associations that you are currently involved with.
(For example, secular third-order, Schoenstatt, Knights of Columbus, etc.)



Education and Formation

What high school did you attend (name of school, city and state)?


List all colleges and universities attended, with graduation dates and degrees earned, if applicable, listing both majors and minors.


List any special training or educational/formational experiences or certification that you have received
(e.g. workshops, FOREM certification, LIMEX certification)


What kind of religious books or periodicals have you read in the past five years?


What have you done since high school to continue your faith development and religious education?
What types of programs have you attended in the areas of theology, scripture and spirituality?




Why have you signed up for the Diocesan Lay Institute?