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The Women of Excellence at GENESIS BAPTIST CHURCH
- College Student Gift Card Application
For College Students who are
MEMBERS
of Genesis Baptist Church
Must submit application in order to be considered
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* Required
First Name
*
Your answer
Last Name
*
Your answer
Mailing Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Phone Number
*
Your answer
Alternate Phone Number
Your answer
Email Address
*
Your answer
Name of College or University
*
Your answer
Classification
*
Freshman
Sophomore
Junior
Senior
Graduate School
Doctoral Student
Option 7
Parent's Name(s)
*
Your answer
Please return this form by Monday, February 20, 2023
Questions? Contact
Mrs. Audrey Ray, Audrey.uncg.ray@gmail.com
Or
Mrs. Gloria White, Gloria430@bellesouth.net
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