HarvestLA Student Ministries Directory
Please fill out this form to be added onto the new directory.
Name of Student *
Your answer
Student Birthday *
MM
/
DD
/
YYYY
Student School *
Your answer
Student Email (if you don't have one, please fill this space with findme@my.parents) *
Your answer
Student phone number
Your answer
Name of Parent *
Your answer
Parent Email *
Your answer
Parent phone number
Your answer
Comments or additional ways to contact you:
Your answer
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