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Adopt-A-Student Xtreme Life College Ministries will once again sponsor an Adopt-A-Student program to provide "a family away from family" for college students.   We will match students with families from Church on Mill. To register, please fill out the information on this screen as completely as possible so your request can be processed in a timely manner.   Note that fields marked with an * are required. Name* Age* Year: *Select* Freshman Sophomore Junior Senior Graduate Major: Course Load: *Select* Light (12-13 Hours) Moderate (14-16 Hours) Heavy (17-20 Hours) Killer (21+ Hours) School Contact Info Street Address:* City:* State:* Zip:* Phone Number:* E-Mail Address:* Primary Mode of Transportation*: *Select* Car Bike Bus Two Feet Home Contact Info Street Address: City: State: Zip: Country of Origin: Favorite Food: Hobbies: Siblings? *Select* Yes No If Yes, How Many? Pet Allergies*? *Select* No Yes If Yes, please specify: Food Allergies*? *Select* No Yes If Yes, please specify: In My Free Time, I Like to: If I Could Go Anywhere on Vacation, I Would Go to: My Favorite Thing to do with My Family is:

Contact Student Pastor Bill Heaton for questions and comments. © 2008 All rights reserved