Your Name:  

Street Address:  

City, State, and Zip Code:  

Phone Number (with Area Code):  

Cell Number (with Area Code):  

Your Current Grade in School:  

The School You Attend:  

Birth Date:  

Your Parent or Legal Guardian's Name:  

Your Parent or Legal Guardian's Phone Number (with Area Code):  

Do you have any health conditions that we should be made aware of:  

Your E-mail:  

Do you have a personal web-site or Blog? If so what is the URL:  

Do you have a MySpace account? If so what is the URL:  

Do you have a FaceBook account? If so what is the URL:  

Are you a member of Woodland Presbyterian Church? YES  NO

If you answered NO, are you a member of another church? YES  NO

If you attend another church, what church do you attend?

If you are not a member of any church, would you like to receive information about how you 

can join our family here at Woodland?YES  NO

Tell us a little bit about yourself.  What are your likes and dislikes?  How many brothers and sisters do you have? What activities are you involved in at home, church or school (hobbies, band, theater, sports, gamer, etc)? :