Wait List: SE Christian Students Conference
Basic and Contact Information
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Age
*
Gender
*
Male
Female
School/Occupation
What school do you attend?
*
Please Select
High school senior
Auburn, AL: Auburn University
Birmingham, AL: University of Alabama
Athens, GA: University of Georgia
Athens, GA: University of North Georgia
Kennesaw, GA: Kennesaw State University
Atlanta, GA: Georgia Institute of Technology
Atlanta, GA: Georgia State University
Boca Raton, FL: Florida Atlantic University
Ft. Lauderdale, FL: Broward University
Ft. Lauderdale, FL: Nova Southwestern University
Ft. Myers, FL: Florida Gulf Coast University
Gainesville, FL: Sante Fe College
Gainesville, FL: University of Florida
Jacksonville, FL: Florida State College
Miami, FL: Florida International University
Miami, FL: Miami-Dade College
Tallahassee, FL: Florida State University
Tampa, FL: University of South Florida
Orlando, FL: University of Central Florida
Orlando, FL: Valencia College
Chapel Hill, NC: University of North Carolina
Charlotte, NC: University of North Carolina
Durham, NC: Duke University
Raleigh, NC: North Carolina State University
Clemson, SC: Clemson University
Columbia, SC: University of South Carolina
Chattanooga, TN: University of Tennessee Chattanooga
Knoxville, TN: University of Tennessee
Murfreesboro, TN: Middle Tennessee State University
Other
I am not currently a student
What is the name of your school?
Locality/city
*
Please Select
Auburn, AL
Birmingham, AL
Athens, GA
Atlanta, GA
Kennesaw, GA
Boca Raton, FL
Ft. Lauderdale, FL
Ft. Myers, FL
Gainesville, FL
Jacksonville, FL
Miami, FL
Tallahassee, FL
Tampa, FL
Orlando, FL
Chapel Hill, NC
Charlotte, NC
Durham, NC
Raleigh, NC
Clemson, SC
Columbia, SC
Chattanooga, TN
Knoxville, TN
Murfreesboro, TN
Other
What city are you from?
Year in school
*
Freshman
Sophomore
Junior
Senior +
Graduate
High school senior
Staff
Not currently in school
What is the name of the serving one who will be attending the conference with you? ***MUST BE SAME GENDER AS STUDENT***
First Name
Last Name
Phone number of serving one
Please enter a valid phone number.
Name of parent/guardian
First Name
Last Name
Email address for parent/guardian
example@example.com
How are you registering for this conference?
*
As a participant
As a serving one
What best describes you?
Student
Recent college graduate
Working / not in school
What best describes you?
Campus team member
Community saint
Allergies
Allergies or dietary restrictions
Nut allergy
Gluten-free
Lactose intolerant
Vegetarian
Other
List your allergy or restriction here
Emergency Contact Information
Emergency contact's name
*
First Name
Last Name
Emergency contact's relationship to you
*
Emergency contact's phone number
*
Please enter a valid phone number.
Other information
When will you arrive?
*
On time: Between 6:00 and 7:00
During the meeting or a little later: Between 7:00 and 10:00
Is this your first SE Christian Students Conference?
*
Yes
No
Submit
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