MLC High School Student Information Request Form
Please note that only one entry can be submitted at a time. Thankfully, it goes quickly. To add another student, simply click "Submit." Thank you for your time and assistance in motivating young people to consider the public ministry. God’s richest blessings to you in your ministry!
Student first name *
Please enter legal first name, not a nickname
Your answer
Student last name *
Your answer
Gender *
Street address *
Your answer
City *
Your answer
State *
Your answer
ZIP code *
Your answer
Email address
Your answer
Church name, city, and state *
Your answer
This church has no members that are high school students
If your church has no members that are high school students, check the box and click on "Submit." Otherwise, skip this question.
High school name
Your answer
Other information about this student
talents/gifts, interests, music, athletics, etc
Your answer
Submit
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