PLEASE READ CAREFULLY
Welcome to the Sacred Heart of Jesus Catholic Student Association! We want you to be a part of our family and feel at
home! Please fill out this form which will allow us to inform you about our activities and events and help us to make this
place safe and accessible for you at all times. Every college student is required to fill out the registration form and
provide necessary information together with emergency contacts. All your information is secure and will not be used
or shared outside our ministry. We would like you to use our Center not only during regular hours when it is open for
everybody, but also when you want to study, pray or just hang out so we made it accessible 24/7. After you return this
form, you will receive a confirmation e-mail with a personal, unique access code for the center. Please DO NOT share
this code with anyone. We also ask you to be responsible and help us take care of this place so please be sure to leave it
nice for others.

* = Required Field

Student Registration Form
Student's Information
Student's Address
Church Information
Name of parish and city
Parent's Information
Father's Address
Mother's Address (if different from above)
Name and Phone Number