Certificate in Ministry Studies Registration if paying with check or money order Name* First Last Parish/School*Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*Work PhoneEmail* I would like to register as (please check one):* Individual Parish/School Team Registration Fee* $20 Individual enrolled in the full two-year certificate process (Cost for course materials) Certificate in Ministry Studies Total $0.00 Please make your check payable to the Diocese of Scranton (Memo: Certificate in Ministry Studies Program) and mail to Office for Parish Life, Attn: Kitty Scanlan, Diocesan Pastoral Center 330 Wyoming Avenue Scranton, PA 18503 Δ