I) Student Information

 Male       Female

Name        D.O.B.      Age     

Address       

City      State      Zip 

Grade     School  

  Member of RUMC           Visitor           Guest of:

Best Phone to Contact You:

Please rank the meeting times below from 1-4, 1 being the best time for you to meet and 4 being the worst.

Sundays 4:30-6:00p.m.

Sundays 8:00-9:30p.m.

Tuesdays 7:00-8:30p.m.

Wednesdays 7:30-9:00p.m.