Group Registration Form

Parish Code	If you received a code from your parish, please enter it here. Otherwise, leave this field blank.
Group Name*
Your Name*	Title	Title	First Name*	First Name*	Last Name*	Last Name*
Your Email*
Password*
Re-Enter Password*

Select a quantity below to receive an estimated total. The final total will be determined by the number of group members who complete their Catholic Discipleship Profile.

Item	Price	Qty	Total
Catholic Discipleship Profile - Group	$6.95 each		$55.60
Have a promo code? Enter it here:		Estimated Total	$55.60*
*The actual total will vary depending on the number of group members who complete their CDP.

Item: Catholic Discipleship Profile - Group

Price: $6.95

Qty:

Total: $55.60*

*The actual total will vary depending on the number of group members who complete their CDP.

Have a promo code? Enter it here:

Please select a billing method*

Each group member will pay for their CDP report.
The group leader will pay for all CDP reports.
Each group member will have the option to pay for their own report. If they decline, the group leader will pay for the group member's CDP report.

Please enter your payment information below. Your card will not be charged immediately.
Card Number*
Card Expiration*	/
Address Line 1*
Address Line 2
City*		State	Zip*

Please confirm your details below.
Parish
Group Name
Name
Email
Purchase Description	Catholic Discipleship Profile - Group
Billing Method
Price Per Completed CDP	$6.95
Card Number
I understand that after 30 days I will be charged automatically for all group members who completed the CDP and did not pay for their own report.
I understand that after 30 days if less than 8 group members complete the CDP, I will be charged an additional $1 for each completed CDP.
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