Name of Student Name __________________________ __________________________ _____________________ Parents Address __________________________ __________________________ ___________________ _________________________ __________________________ ____________________ Phone Number: ( ) ________________ Cell Phone Number: ( ) ____________________ Birth Date of Student __________________________ __________________________ ______________ Year in School: __________________________ __________________________ ____________________ Hobbies (ex: sports—favorite team, etc., reading, computers)_______________ ______________________ __________________________ __________________________ __________________________ ______ Favorite Snack (cookies, candies, etc.) __________________________ __________________________ ___ Any food Allergies: __________________________ __________________ ______________ ___________ Favorite Soup/Other Instant Food (example: macaroni & cheese) ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ Favorite Magazine or Books ______________ ______________ ______________ ______________ ______ School Colors and Mascot ______________ ______________ ______________ ______________ ________ Major or Area of Interest ______________ ______________ ______________ ______________ _______ Dates of Exams (approximate if possible) ______________ ______________ ______________ __________ Additional Comments: ______________ ______________ ______________ ______________ ___________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________

Church Mouse College Student Information Form: Name of Student _________________________________________________________ Name of School __________________________________________________________ Student's Address:________________________________________________________ ________________________________________________________________________ UPS or Package Address (sometimes different than dorm address): ______________ ________________________________________________________________________ ________________________________________________________________________ Phone Number: ( ) ________________ Cell Phone Number: ( ) ____________________ Parent's Name ___________________________________________________________ Parents Address _________________________________________________Pleas______ _________________________________________________________________________ Birth Date of Student ______________________________________________________ Year in School: ____________________________________________________________ Hobbies (ex: sports-favorite team, etc., reading, computers) ________________________________________________________________________ __________________________________________________________________________ Favorite Snack (cookies, candies, etc.) __________________________________________ Any food Allergies: _________________________________________________________ Favorite Soup/Other Instant Food (example: macaroni & cheese) __________________________________________________________________________ __________________________________________________________________________ Favorite Magazine or Books __________________________________________________ School Colors and Mascot ___________________________________________________ Major or Area of Interest ____________________________________________________ Dates of Exams (approximate if possible) ______________________________________ Additional Comments: __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ ____________________ __________________________________________________________________________ __________ __________________________________________________________________________ __________

Please copy and paste this into a Word document, print, fill out and mail back to the Church.

First Presbyterian Church 234 East Main Street Rock Hill, SC 29730