Join The Newman Club

 

THIS FORM IS TEMPORARLY UNAVAILAIBLE  -- please email kiesewettj1@mymail.nku.edu  with your name, and email address for more information. 

 

If you are interested in joining or want more information about the Catholic Newman Club, please fill out the form below.

NOTE: If you are unsure about joining the club please fill out the form below and we will send you more information. 

 

Name:

Address

City, State, Zip

Telephone:

H: C: Dorm:

E-mail address:

ISO number

Category:

Student      Faculty      Staff      Volunteer

If student:

Freshman       Sophomore       Junior       Senior
Graduate       Law school
Major or Field:
Do you live on campus? Yes       No

Dorm Building

Wing           Wing & Room Number  

Home Parish:

Special Interests:

Parents' names:

Parents' address:

City, State, Zip

Parents' telephone: