Refer a Student

Alumni Refer-a-Student Form

Please share as much contact information as possible about the student you are referring.
Referral Name:*

FirstLast
Referral E-mail:
example@example.com
Referral Phone:
Referral Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
What is your relationship to this potential student?
Information About You

Please give us some information about yourself so we can follow-up as needed.
Your Name:*

First NameLast Name
Your Phone:
Your E-mail:*
example@example.com
What is your relationship to Elim?
Are you interested in learning more about being an Elim Alumni Ambassador - sharing your Elim story, connecting with potential students and more?

YesNo
Thank you so much! I look forward to partnering together! I would love to do a brief zoom call with you to connect and answer any questions you might have. Please jot down some upcoming dates/times that work for you and I will send you a zoom link.
Any additional comments:
Should be Empty:

Alumni Refer-a-Student Form