Independent Presbyterian Church
Wednesday, July 23, 2014

Contact Information College Students

 
NOTE:   TWO SEPARATE FORMS TO FILL OUT:
 
FORM ONE:
Contact Information Sheet for IPC College Students
 
We want to stay in touch with you while you're away at college!
Fill this out & click "Submit"  below and you'll see FORM TWO to fill out. That's all!
 
Date (Month/Day/Year):  
Student's Name:
Student's Birth Date (Month/Day/Year) 
Male  
Female 
Home Street Address: 
City, State, Zip: 
Parents' Names: 
Name of college/university: 
Student's Mailing Address at College: 
Package address at College if different than mailing address: 
Will Address Likely Change in Spring 2013?   Yes      No
Student's Phone Number at College: 
Student's Cell Phone:
Student's Email: 
Alternate Home Email Address (if applicable):
High School Attended: 
Year of High School Graduation:
College Major (if decided):
Date of Expected College Graduation (or Graduate School) (month/year): 
Fraternity/Sorority Affiliation (if any):
Approximate Academic Calendar (e.g., mid-August to early December & early January to early May):
 
 Just one more brief form to fill out.  Form Two:  IPC Partners for Students Ministry Form. You'll see it when you click "submit" below.