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Student Interest Form

Please fill out the form below to help us make sure we have the most up-to-date contact information. We use this information to serve you better and respond to needs of the community. Know that your information will be kept confidential and never be shared outside the campus ministry. 


First Name
Last Name



We want to celebrate you!

Address Line 1
Address Line 2
ZIP/Postal Code
Select all that apply!
What year are you planning to graduate? (doesn't have to be exact)

church name, city, state (if no, you can just leave blank)

(any food allergies we should know about?)

(your favorite dinosaur, for example...)