Registration Form

Wedding Anniversary Celebration 2017
Registration Deadline was Wednesday June 7

We will take late registrations but ask that you contact John Joy directly via email or phone so that we do not overlook the late registration. You can reach John at (608) 821-4517 or john.joy@madisondiocese.org.

Thank you.
Registration Form
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- Husband
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Wife
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Wedding Year REQUIRED Please fill out this field. Please enter an integer (number).
- Current Parish REQUIRED Please fill out this field. Please enter valid data.
- Contact Information
- Mailing Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Phone Number Please enter a phone number.
- Email Please enter an email address.
Submit

Wedding Anniversary Celebration 2017