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DIOCESE OF SOUTH-WEST AMERICA          
Campus Ministry & Fellowship Student Registration Form
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Campus Ministry & Fellowship Student Registration Form
This form is being used to compile a national database of all incoming and current students enrolled in post-secondary education within the Diocese of South-West America.

For students who have previously submitted their registration for the 2019-2020 academic year, it is not necessary to re-send information unless you have any updates to your registration or to ensure you have been registered.

The collected information will not be published and will remain confidential and be solely used by the assigned campus ministry coordinators and leaders to initiate and make contact with students. The primary focus will be 1) connecting students to other identified youth on or near campus and to develop a local campus ministry unit where applicable  2) connecting students to local Orthodox parishes where applicable and with clergy and other student leaders 3) and for the development of ministerial outreach and support programs while youth are enrolled in post-secondary education. This form is intended to be completed for each individual student.

For further information, please visit www.ds-wa.org/campusministry or e-mail dswa.campusministry@gmail.com
Name (Last Name, First Name) *
College or University *
City, State (of College or University) *
Projected Graduation Year
Major/Field of Study *
Phone Number (of Student or Parent) *
Email (of Student) *
Home Parish (Name/City) *
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