Last Name:
Phone Numbers while at TECH (area code and phone number):
(Cell) (residence hall or apartment)
Mailing address while at the TECH (leave blank if you don't know yet):
Street or P.O.: City: AR Zip:
Where I will be living while at TECH: -- Choose -- Residence Hall Apartment At Home
Intended Major: Classification (for transfer students: Freshmen Sophomore Junior Senior Grad Student
Permanent mailing address:
Street or P.O. City State AR AL AK AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip
Permanent Home Phone (area code and phone number):
What do you enjoy doing (hobbies, interests, etc.)?
If you have a home church, what is the name of the church?
What are you interested in? Select as many as you want.
FROGS
FMT - Freshman Ministry Team
AGE TO AGE
CIRCUIT RIDERS
D-GROUPS
ACTS
SONG OF SOLOMON
CROSS CULTURE
CARE - Nursing Home Ministry
Retreats
Local mission projects
Spring Break mission trips
Intramurals
Would you be interested in sharing your talents with Wesley? Please list talents:
How did you hear about Wesley?
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