EmailMe Form - St. James Fine Arts Department Registration Form

Name *

First Last

Date of Birth *

MM / DD / YYYY

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Primary Phone *

### - ### - ####

Alternate Phone *

### - ### - ####

Email *

Checkbox *

Accepted CHRIST as Your Personal Savior *

Yes

No

Attend Church School and/or Bible Study *

Yes

No

Name *

First Last

Relationship *

Phone *

### - ### - ####

Email *