Emmanuel Students - Autumn '17

Please fill in the form below if you would like to be known as an 'Emmanuel Student'.
It really helps us in supporting you if we know a little about you and how to contact you if necessary
All personal details will be held securely and can only accessed by members of the student team.

 

Name:
I am male       I am female 
 
Address (term time):
 
Town:
Postcode:
Mobile:
Email Address:

Where do you come from? 


Do you have a home church?  yes   no 

Name of your home church:   

 

What course are you doing? 

 

What year are you in now?  

How long is your course? 

 

If necessary, what is the best way to contact you? [tick all that apply]

Phone call 
Text mesage 
Whatsapp 
Facebook   (I have joined the Emmanuel Students Facebook group )
E-mail 
Other

[please specify] 

 

Do you have any particular needs or concerns which you would like us to know about?

Do you have any questions to ask us?


 



 

 
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