Local Church College Student Info

Please send your college student's information to the Wesley Foundation/Campus Ministry so that the Campus Minister/Director may contact them. Fill out the form below and click on the bottom button when you are finished.

Please fill in your personnal contact information below.

*First Name
*Last Name
*Email
*Students Permanent Residence*

Please supply the following information:

Student's Name
Home Address
Home City
Home State
Zipcode
Home Phone
Personal Email
Local Church Name and City
 

*Please Select One:
Student is currently enrolled at this university/college
Prospective Student for the future
*School Information University/College
Student's School Information

Please supply as much as possible of the following information: (this is information is important for the Campus Minister to be able to contact the student)

Student's School Address
Dorm or Apt #
Room Number
City
State
Zipcode
Student's Phone #
Student's School Email

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