Discernment Day Registration

St. Clement Catholic Church
Plant City, Florida

ENVISION COMMUNICATION SITE

ENVISION Discernment Day Registration Form

Date:	July 15, 2007
Time:	12:00 Noon to 6:30 p.m.
	(Lunch and snacks will be provided during the day)
Place:	Cronin Hall

Please complete the form below for online registration. You will receive an email confirmation of your registration.

Parishioner Name:
Address:
City, State, Zip:
Daytime Phone Number:
Evening Phone Number:
E-mail Address:
Please Select One:
Child Care Needed?	Yes No
Number of Children:	(Please note: child must not require diapers. Thank you.)
Age of children (if applicable):	Please separate each child's age with a comma. Thank you.
Please list the parish committees or groups to which you currently belong:

Once you have completed the form, please send it to us by clicking on the 'Submit' button below. Thank you very much for becoming a part of ENVISION: Planning Our Parish Future and Discernment Day.

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Copyright 2006 by St. Clement Parish.
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Last updated: 04/06/07.