Quick Parish Database Update Form

Quick Parish Database Update Form
Adult 1 in Household *

First Name Last Name
Adult 2 in Household

First Name Last Name
Address *

Street Address

City State

Zip Code
Adult 1 Email address *
example@example.com
Adult 2 Email address
example@example.com
Home Phone - If you have a land line
Please enter a valid phone number.
Adult 1 Cell Phone *
Please enter a valid phone number.
Adult 2 Cell Phone
Please enter a valid phone number.
Please check which applies. *

NIU or KISH Staff/Faculty NIU or KISH Student NIU Alumni No Affiliation to NIU or KISH
Please select the one that applies. We are not using this to check up on people attending Mass :) We just want a current and correct database! Thank you! *

I am still in the area (or visit often) and wish to continue to attend Mass at the Newman Center/Christ the Teacher University Parish. Please keep me in the Church database! I am no longer in the area to attend Mass or attend a different church and I would like to be removed from the Church database.
Please select the one that applies. *

I am an Alumni of NIU and would like to remain in the Alumni database to receive The Newman Now and other promotional pieces about the Newman Center. I am an Alumni of NIU but no longer wish to receive the Newman Now and other promotional pieces. I am not an Alumni of NIU.
Any questions or comments?
Should be Empty: