Campus Ministry Student Referral Form

Welcome to the INUMC College Connection and thank you for visiting. Our campus ministers deeply desire to be in ministry with you, together nurturing, loving, and caring for our students. By filling out the form below for any students you know attending colleges and universities in Indiana where there is a UMC-affiliated campus ministry, you'll be helping those students make a Christ-centered connection on their college campus. The information you share will be forwarded directly to the campus minister or chaplain. Thank you, and we look forward to joining you in ministry with these young people!

* required field

Campus Ministry *	Depauw University Hanover College Indiana State University Indiana Tech - Fort Wayne Indiana University IPFW Ivy Tech - Bloomington Purdue University Rose-Hulman Institute of Technology St. Mary-of-the-Woods College University of Evansville University of Indianapolis Vincennes University Campus Ministry is required
Referrer Name
Referrer Email
Student Name *	Student name is required
Student Email *	Email is required
Student School Email
Student School Address
Student Home Address
Student Home Church
Student Phone *	Phone is required
Student Cell Phone
Enter Security Code *