Diocese of Scranton Pastoral Formation Institute Registration Form

Directions: Fill out student, course, and billing information completely. All information on this form is strictly confidential and is the only way to maintain accurate records of your course work. Please register early. Courses lacking set minimum enrollment may be canceled five days prior to start date. One applicant and one course per registration form. Registration forms may be copied as necessary.

*(denotes required field)

Name:*

Social Security Number*

Address*

City/State/Zip*

Phone (Day)*

Phone (Evening)

E-Mail Address

Parish*

Parish City

Parish Phone

Please indicate the PFI program in which you would like to enroll:
Level 1:

Parish Ministry Foundations Certificate

Level III:

Select One:

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Deacon Candidate’s Spouse for:

Credit

Audit

Course Name

Course Number

Date of First Class

Class Location

Billing Information (PFI Transcripts will be sent to enrollee and to Pastor/Principal/Payee)

Choose One:

Fee $

Please fill out next section if you checked payee other than Self.

Pastor/Principal’s Name

Phone

Parish/School Name

Address

City/State/Zip

CAPTCHA Code:*

Diocese of Scranton Pastoral Formation Institute Registration Form

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Bishop Joseph C. Bambera

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