2021-2022 JCUMC College Connection Form
The College Ministry Team is in the process of updating our list of college students.

It is our goal to remind our college students that they are loved and in our prayers during their college years. Whether you are going away to school or commuting from home, we want to hear from you!

To make sure we include everyone, we would like college students or their parents to share the following information with our team. College students move frequently. Therefore, even if you were on our mailing list last year, please submit the form again.

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First Name *
Last Name *
Birthday *
MM
/
DD
/
YYYY
College Attending *
Anticipated Graduation Year *
What is the best address to use as you begin the 2020-2021 school year? *
Student's Street Address at School *
City, State, Zip Code of School Address *
Student's Email Address *
Student's Cell Phone *
Student's Street Address At Home *
City, State and Zip of Student's HOME address *
Parent/Guardian Name(s) *
Parent Email Address *
Parent Phone (Home or Cell) *
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