College & Young Adult Connect Card - Florence Baptist Church

Phone number

Gender

Birthdate

Current Life Situation *

College Freshman

College Sophmore

College Junior

College Senior

Not attending College - Working

Post-College - Single

Post-College - Married

If you are attending college, what college?

Are you involved in a college and young adult small group, if so, which one? *

If you aren't connected to a college and young adult small group, would you like more information?

What are your interests and activities?