Saint John Vianney College Seminary Application

Date*
Date
Date Format: MM slash DD slash YYYY
Name*
First Middle Initial Last
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Home Phone*
Cell Phone*
Birthdate*
Grade
Father First and Last Name*
Father's Status*
- Living
- Deceased
Father's Address*
Street Address Address Line 2 City State ZIP Code
Father's Email*
Father's Primary Phone*
Mother First and Last Name*
Mother's Status*
- Living
- Deceased
Mother's Address*
Street Address Address Line 2 City State ZIP Code
Mother's Email*
Mother's Primary Phone*
Diocese*
Parish (include City and State)*
Pastor's Name*
Prefix First Last
Parish Address*
Street Address Address Line 2 City State ZIP Code
Parish Email*
Year of High School Graduation*
Intended Entry Date (e.g. Fall 2020)*
Will be entering UST as a: (e.g., Freshman, Sophomore, Junior, Senior)*
Emergency Contact First and Last Name (please list someone other than a parent)*
Relationship*
Emergency Contact Primary Phone*