Student Information Form

Please fill out this form if you are interested in LCM and wish to receive future mailings from us.

First Name:

Last Name:

Classification -  Please check the appropriate box:
Freshman Sophomore Junior Senior Grad Student TAMS

Other

Attending UNT or TWU):

Email address:

Cell phone #:

Dorm/Room #:

P.O. box #:

OR, local address:
City, State & Zip:  
 

Home address:
City, State & Zip:

Denomination:

Home church:

Birthday:

 

Please copy and paste this form to the following address:    

LCMDenton@msn.com

Thank you for your time in filling out the above. We will get a mailing out to you as soon as possible!!!