2007/08 Wesley Youth Registration Form

 Please help us update our youth group membership by filling out the following form.

       
First Name         MI             Last Name


Street Address

                   
            City                  ST             ZIP Code

Please select birthday:       

Please select school:         Grade:

 Please check the below boxes that apply:
Please continue to send me the Wesley Youth Bytes Newsletter: YES  NO
If YES above please indicate preferred method of delivery below:
Send the Wesley Youth Bytes Newsletter by:  E-Mail   OR   Regular Mail

E-Mail Address:

Phone Number:

Cell Phone:

 Please use the area below to add any additional remarks:

                                                                                                                         

Questions mailto:adult@wesleybloom.org
Copyright © 2006 [Wesley United Methodist Church]. All rights reserved.
Revised: 01/29/08