Disciple Central Community Church

Student Ministry Form

Student Name

Parent Name

Email

Phone Number

Please choose:

I would like to learn more about Student Ministry

I would like to join Student Ministry

What is your preferred method of contact?

Email

Phone

What is your preferred time of contact?

Morning ( 9:00 am - 12:00 pm)

Early Afternoon ( 12:00 pm - 3:00 pm)

Late Afternoon ( 3:00 pm - 6:00 pm)

Evening ( 6:00 pm - 8:00 pm)

What school does your child(ren) attend?