Registro de Agape On the Road Agape Service Project 2023 - RegistrationPor favor, activa JavaScript en tu navegador para completar este formulario.Por 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 ColumbiaFloridaGeorgiaHawaiIdahoIllinoisIndianaIowaKansasKentuckyLuisianaMaineMarylandMassachusettsMíchiganMinnesotaMisisipíMisuriMontanaNebraskaNevadaNuevo 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 25-29 (Unavailable)July 2-6 (Unavailable)July 9-13 (Unavailable)July 16-20 (Unavailable)July 23-27 (Unavailable)July 30-August 3 (Unavailable)August 6-10Agape Weeks - Please indicate your SECOND choice *June 25-29 (Unavailable)July 2-6 (Unavailable)July 9-13 (Unavailable)July 16-20 (Unavailable)July 23-27 (Unavailable)July 30-August 3 (Unavailable)August 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