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
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 send any parish information via: *

US Mail E-mail
Please check the appropriate boxes. *

NIU Staff/Faculty NIU Student NIU Alumni No Affiliation to NIU I wish to remain in the Newman Center database I have moved out of town or to another church and wish to be removed from the Newman Center database
Should be Empty: