Koinonia Registration

Koinonia 61 Registration - SPRING 2021

IMPORTANT NOTE: All those who register online must turn in the $50 in person (at the St. JPII Newman Center) or by mail (501 Main St. Normal, IL 61761)
Thank you!

NK 61 Registration

* Indicates required field

Name *

First

Last

School *

Year *

Expected Graduation Date *

Plan of Study/Major *

Religion *

Local Phone # (Cell) *

Emergency Contact - Name and Relationship *

Emergency Contact Phone # *

Email *

Local Address *

Home Address *

Birthday *

Special Dietary Needs *

How did you hear about the retreat? *

Comment *

Submit