Student Membership Form Student Membership Form Student InformationPlease provide your contact information so that we can contact you about upcoming activities and events. Name* First Last Cell*Email* Field of Study* Year (Ex: 1st year undergraduate, 2 year graduate)* Interests*Tell us what you're interested in, so we can keep you up to speed on ongoing activities and special events: Service Opportunities Young Adult Group/Graduate Student Ministry Bible Study or Small Group One-on-one mentorship/spiritual direction Brotherhood Weekly Dinner Sisterhood Weekly Dinner Parent InformationIn order for your parents to receive our newsletter and other Newman Center updates, please fill out the following information. First Parent Name* First Parent Email* Second Parent Name Second Parent Email Home Address* Street Address City State / Province / Region ZIP / Postal Code Second Home Address (if applicable) Street Address City State / Province / Region ZIP / Postal Code