Adopt a College Student Sign Up
Are you a college student in the 2016-2017 school year? Would you like to receive care packages from Concordia while you're at school? Fill out this form and let us support you during the upcoming school year!
First Name
Your answer
Last Name
Your answer
Street Address 1
***Please enter the address you will be using throughout the school year.
Your answer
Street Address 2
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Cell Phone
(xxx-xxx-xxxx)
Your answer
Email
Your answer
College You Are Attending
Your answer
What year in school are you entering?
Your answer
Please list some items that you like to eat, have as snacks, or restaurants you like to go to.
Starbucks, Chik-fil-A, Protein Bars, Granola Bars, Favorite colors
Your answer
Please list any food allergies.
Your answer
Submit
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