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PARISH Benefits Coordinators Registration Form

- OFFICES

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- FIRST NAME: REQUIRED Please fill out this field. Please enter valid data.
- LAST NAME: REQUIRED Please fill out this field. Please enter valid data.
- LOCATION: REQUIRED Please fill out this field. Please enter valid data.
- POSITION(S): REQUIRED Please fill out this field. Please enter valid data.
- EMAIL: REQUIRED Please fill out this field. Please enter an email address.
- WORK PHONE: REQUIRED Please fill out this field. Please enter valid data.
- WHICH MEETING WILL YOU ATTEND ? (Choose One) REQUIRED September 16 (West Deanery) St. Alphonsus, Maurice September 18 (Central Deanery) Chancery September 24 (South Deanery) Sacred Heart of Jesus, New Iberia September 25 (North Deanery) St. Charles Borromeo, Grand Coteau Please fill out this field.
- Will Your Pastor Be Attending? REQUIRED YES NO Please fill out this field.
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