Student Registration Form
The Student/Family Adoption Program is a ministry of Blacksburg United Methodist Church that has enriched the lives of many students and families through the years.  If you would like to participate in this ministry, please complete the Student Registration Form below!
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Email *
Name *
Cell Phone *
Local Address
Home Church
Which service do you usually attend?
Clear selection
Which class are you in for 2019-2020?
Clear selection
Major(s) and/or Minor(s)
List your interest/hobbies/talents:
List the campus organizations to which you belong:
Have you participated in this program previously, and have a family you wish to continue with? If so, write their name(s):
Food allergies/other notes:
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