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| First Name | |
| Last Name | |
| Address Line 1 | |
| Address Line 2 | |
| City | |
| State | |
| Zip Code | |
| Daytime Phone | () - |
| E-mail Address | |
| College/University name, City, State: | |
| Are you graduate, undergraduate, professors | |
| Answer all the following questions with Yes or No or Write a Comment | |
| Comments | |
| I'd like to serve as a coordinator for: my college, my town, my state, a US/Canda region | |
| Serve a a writer for brochures, flyers, advertisements, articles, etc. Or in Editing | |
| Wok with Website and/or graphics, and/or Facebook | |
| Help in events | |
| Prepare materials for Catechism classes | |
| Prepare Q&A for meetings | |
| Prepare simple Bible study lessons | |
| Prepare topics for meetings | |
| Help in club needs (banners, t-shirts, Gospels, etc.) | |
| Lead prayer meetings to support the activities of the fellowships | |
| Help in communication | |
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