SC Lutheran Campus Ministry
Student Information Form

Please help us enter your name and address in our data base. Here is the information we would like to have.
You may cut and paste this into an email message and send it to us; the address is below.


Name: ________________________________________________

Permanent Mailing Address:  _______________________________

_____________________________________________________

Email Address:  ___________________________

Home Congregation:  _______________________

 School attending:  _________________________

Anticipated date of graduation:  ________________

Would you like to be added to the Gulf Atlantic LSM E-mail list? _____

Would you like to receive email devotions from Pastor Chris Heavner, campus pastor at Clemson University?  _____

Please send form to PastorC@Clemson.edu