Student Contact Info 2019 Student Contact Info Fill out this form to be added and/or update your info to our contact list. You will receive updated info on current events and happenings in our Student Ministry. General InfoName* First Last Parent's Name* Mom Dad Personal InfoBirthday*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920School*Grade*Contact InfoPlease list the phone and email address that would be the best way to contact you and your parentsPrimary Phone*Primary Email* Additional InfoPlease list any additional info that may be helpful:
