PDCBWC 2025 Campus Ministry Form
Whether you have an incoming Freshman or a seasoned student, we would love to warmly welcome them to one of our Campus Ministry programs this Fall! Please provide contact information below so that assigned staff can connect with you and with them.
Date
-
Month
-
Day
Year
Date
Your Information
Please complete this section as the person submitting this form.
Your Name:
*
First Name
Last Name
Email:
*
example@example.com
Church Name
*
Church Location
*
Street Address
Street Address Line 2
City
State
Zip Code
Relationship to Student:
*
Church Member
Parent
Pastor
Self (I am the student)
Student's Information
Please provide the STUDENT's information in this section.
Student's Name:
*
First Name
Last Name
Student's Email:
*
example@example.com
Student's Phone Number:
*
Please enter a valid phone number.
Select which campus the student is or will be attending:
*
Please Select
American University
Bowie State University
Delaware State University
Frostburg State University
Howard University
Morgan State University
Salisbury University
Towson University
University of Delaware
University of MD College Park
University of MD Eastern Shore
Submit
Should be Empty: