Student Connection Form
Email address *
Name? *
Your answer
Phone? *
Your answer
Current School Attending?
Your answer
On a scale of 1-10, how confident are you that you will spend an eternity with Jesus?
My prayer request is...
Your answer
If you were to stand before God, and he were to ask you “Why should I let you into my Kingdom?”, what would you say?
Your answer
I have a suggestion:
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I would like to:
Is this your first time filling out this form? If yes, please answer all the questions. If no, than you may stop here. *
I found out about LifePoint Students through:
I am:
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