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Student Application: Rooted - College Age Ministry

Student Application to connect with LCC families

Your name *

Last name

Email address *

Phone number

Phone type

Preferred number for contact:

Address *

Country

Street address

Apt/unit/box (optional)

City

State

Postal code

What college are you attending? *

What is your current year of college (freshman, sophomore, etc) and expected graduation date? *

Please tell us a little about yourself so we can match you up with a family.

Check all that apply

I prefer the outdoors

I love family game nights

I like to cook

I enjoy sports

I have my own transportation

I don't have a vehicle available at school

My family does not live in East Texas and/or lives out of the country

Other

I am allergic to

While at school, I am far from home and I'm open to the idea of participating in holiday festivities with another family.

Yes, that sounds interesting - If I'm unable to return home

Not this school year

Maybe

Other

If I can't be face to face, then I prefer to communicate:

via text

phone calls

Other

Are there any families that you already have a connection with and would like to be paired up with?

Please note that you are not guaranteed to get the family that you request, but we will try our best

Please confirm your permission to share your contact information with your host family (select checkbox) *

Thank you for your interest in Rooted Ministry!

I will be contacting you soon to let you know which family you've been paired with at Longview Christian Church. Please contact us if you have any more questions.

Carl and Joan Fudala

Carl: 254-291-2291 / carl.fudala@gmail.com
Joan: 254-681-9468 / joan.fudala@gmail.com

Longview Christian Church
office@longviewchristian.com
903-758-6868

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