Registro de Agape On the Road Agape Service Project 2023 - RegistrationPor favor, activa JavaScript en tu navegador para completar este formulario.Group Leader Name *NombreApellidosPosition *(ex: Youth Minister, Teacher, Volunteer, etc.)Email *Work PhoneCell Phone *Parish / School *Parish / School Address *Dirección (línea 1)Dirección 2CiudadAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrito de ColumbiaFloridaGeorgiaHawaiIdahoIllinoisIndianaIowaKansasKentuckyLuisianaMaineMarylandMassachusettsMíchiganMinnesotaMisisipiMisuriMontanaNebraskaNevadaNuevo HampshireNueva JerseyNuevo MéxicoNueva YorkCarolina del norteDakota del norteOhioOklahomaOregónPensilvaniaRhode IslandCarolina del SurDakota del SurTennesseeTexasUtahVermontVirginiaWashingtonVirginia OccidentalWisconsinWyomingProvinciaCódigo PostalSelect the age group of your participants *6th - 8th grade9th - 12th grade6th - 12th gradeEstimated number of youth participants *Estimated number of adult participants *Agape Weeks - Please indicate your FIRST choice *June 25-29July 2-6July 9-13July 16-20July 23-27 (Unavailable)July 30-August 3August 6-10Agape Weeks - Please indicate your SECOND choice (copy) *June 25-29July 2-6July 9-13July 16-20July 23-27 (Unavailable)July 30-August 3August 6-10If you agree to the following terms, please respond ‘Yes’: *NoYesIf you agree to the following terms, please respond ‘Yes’: I have read the registration brochure and understand the registration policies, including that upon submission of this registration form, the Archdiocese will invoice the parish for the $500 non-refundable registration fee.Do you have any questions or comments?Submit