Alumni Referral

Prospect Referral Form

Instructions: Please fill out all the required information (*). Any additional information you can provide below will be greatly appreciated. To refer multiple prospects, please submit information for each student on separate online forms.

Contact Information 1. Full name of prospective student*

*At least one of the following forms of contact information for the prospective student:

2. Prospect's email address 3. Prospect's cell phone number 4. Prospect’s home phone number Prospect’s postal address:

5. Street address 6. City 7. State 8. Zip code 9. Prospect's Gender
MaleFemale

Additional Information 10. Name of prospect’s high school 11. Prospect’s high school graduation date (year only) 12. Name of prospect’s church 13. Name of prospect’s pastor 14. Name of prospect’s youth pastor 15. Special interests, skills, talents of prospect Your name and any of your contact information which you are willing to provide:

16. *May we tell the prospective student that you referred him/her to us?*
YesNo

17. Your relationship to prospect 18. How long have you known prospect 19. Additional comments about prospect

* Information is Required