2011 SEED Form for Youth
Exit this survey

1. SEED - Serving Everywhere, Exemplifying Discipleship

Dranesville United Methodist Church
Youth SEED Form January 2012 - December 2012
(For youth in grades 6-12)

Please complete all the personal information before moving to the various service categories.

I will serve in the following activities for January 2012 - December 2012:

*
1. Last Name

Last Name

*
2. First Name

First Name

*
3. Birthdate

MM DD YYYY
Birthdate / /

Birthdate MM DD YYYY Birthdate / /

*
4. School

School

*
5. Grade

Grade

*
6. Address

Address

*
7. City

City

*
8. Zip Code

Zip Code

9. Phone (if applicable, please enter your home phone number)

Phone (if applicable, please enter your home phone number)

10. Cell Phone (if applicable, please enter an alternative number at which to be contacted)

Cell Phone (if applicable, please enter an alternative number at which to be contacted)

11. E-mail (please enter your e-mail address so that you can be contacted regarding your selected activities)

E-mail (please enter your e-mail address so that you can be contacted regarding your selected activities)

2011 SEED Form for YouthExit this survey

1. SEED - Serving Everywhere, Exemplifying Discipleship

*1. Last Name

*2. First Name

*3. Birthdate MM DD YYYY Birthdate / /

*4. School

*5. Grade

*6. Address

*7. City

*8. Zip Code