Diocese of Madison
St. Therese of Lisieux Lecture Series


Christopher West - Friday, Feb. 19

Online Registration

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

Group registration is allowed for this event. Please limit group size to actual requirements.
Every group or individual should register using this online form.
If you have questions, please call 608-821-3160 or e-mail OEC@straphael.org.



First Name:
Last Name:

Parish:
City where parish is located:

Number of people in group:     (Limit 4 per registration.)

Email Address:
Daytime phone:

Your preferred mailing address:
     Street address:
     City:
     State:
     Zip:

Any special needs: