PCC Apprentice Get To Know You Form

General Info

Name*

First Middle Last

Birth Date*

Home Phone*

Cell Phone

Work Phone

Which number is best for reaching you?

What time of day is best for contacting you?

Ok to text you?*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email*

* We primarily communicate through email.

School

Grade

Place of employment

Ok to call you at work?

Parent's Name*

First Last

Home Phone

Cell Phone

Emergency Contact

First Last

Emergency Contact's Phone

What campus do you attend?*

Where would you like to volunteer at your campus? (Select all that apply)*

Please visit link at the top of this page for a list of positions and descriptions.

If Other, please list interests:

When are you available to serve? (Select as many as are applicable if you are willing to serve for more than one service on a Sunday)*