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First Name:
Last Name:
Gender:
Male
Female
Date of Birth (mm dd yyyy):
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State:
Zip Code:
Cell Phone:
May we send you text messages:
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Email Address:
Primary Academic Interest:
-- Select --
Biblical Thought and Literature
Business Administration
Counseling Psychology
Family, Youth, and Community Life
General Ministry
Inter-Cultural Studies
Music
Pastoral Leadership
Sport Management
Other
Secondary Academic Interest:
-- Select --
Biblical Thought and Literature
Business Administration
Counseling Psychology
Family, Youth, and Community Life
General Ministry
Inter-Cultural Studies
Music
Pastoral Leadership
Sport Management
Other
Undecided
High School Name:
Year of High School Graduation:
Intended Start Date at Crossroads:
-- Select --
Fall 2011
Spring 2011
Other
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Home Church Denomination:
Select the event you will be attending:
Fall OverKnight Visit; October 13-14, 2011
Thursdays @ Crossroads; November 10, 2011
Thursdays @ Crossroads; January 26, 2012
Thursdays @ Crossroads; February 16, 2012
Thursdays @ Crossroads; March 8, 2012
Spring OverKnight Visit; April 12-13, 2012
Please list the names of any Crossroads students you would like to stay with:
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920 Mayowood Road SW - Rochester, MN 55902, USA
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