* 1. Please enter your first and last name.

* 2. Please enter your cell phone number.

* 3. Do you wish to receive text messages from NHBC Student Ministries?

* 4. To receive text messages, we need to know your cell phone service provider (Verizon, AT&T, etc). If you entered "Yes" in #3, please enter your provider name. If you selected "No", please enter "N/A".

* 5. Please enter your primary email address.

* 6. Please enter any additional email addresses that you wish us to have.

* 7. Please enter your home phone number.

* 8. Which category best describes your involvement in the Student Ministry?