Youth and Young Adult Ministry - Diocese of Grand Island

1225 S. Poplar St, Suite 100
North Platte, NE 69103
Toll-Free: (800)252-9325
Phone: (308)532-2707
Fax: (308)532-3574

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First Name: MI: Last Name:

Sex: Male Female Date of Birth

Grade Next Fall: Age:

Address:

City: State: ZIP:

Home Phone:

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Parish:

E-mail:

Please choose a t-shirt size (cost is included in registration cost):

Choose one of the following options:

Higher Ground

First Choice Second Choice Third Choice

May 24-29, 2009

May 31-June 5, 2009 2009 Applications will be accepted beginning in March 2009

June 7-12, 2009

Higher Ground II

	First Choice	Second Choice
May 24-29, 2009	2009 Applications will be accepted beginning in March 2009
May 31 - June 5, 2009	2009 Applications will be accepted beginning in March 2009

Higher Ground College Retreat (III)

May 18-23, 2009

2009 Applications will be accepted
beginning in March 2009

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