* 1. For which NCYAMA course are you registering?

* 2. To register for the course, please fill out the following fields.

* 3. Are you a young adult (age 18 to 39) yourself?

* 4. Are you currently a ministry graduate student at another college or university?

* 5. If you marked "YES" to the question above, please tell us the name of your university/college, your degree program, and how far along in your coursework you are now. If you marked "NO," you may skip this question.

* 6. What area of church ministry are you currently engaged in or that most relates to the reason for taking this class/workshop? (you may answer with more than one option)

* 7. How many years have you worked or been involved in church ministry at your current location?

* 8. Why are you interested in taking a course on the evangelization of inactive and disaffected young adults? (in knowing this background info, the course will be able to meet the needs of the students and participants)

Your registration is not yet complete. The cost for this course for non-credit-seeking participants is $600 for the 14-week fall semester. Once we receive payment, you will receive confirmation of your registration.

Please make your check payable to "Loyola University Chicago" but send the payment to: NCYAMA c/o Paul Jarzembowski, 101 W. Airport Rd., Romeoville, IL 60446. This registration and payment are due no later than August 25, 2011.