Contact Me

Fill out the form below and a student who lives near you on campus will contact you to tell you more about InterVarsity. Fields denoted with * are required.

*Person completing this form:
StudentParent/GuardianOther

*Student First Name

*Student Last Name

Gender: MaleFemaleOtherPrefer not to say

*Email

*School

Campus Address (dorm & room # or apartment/house address)

Phone

Year in School
FRSOJRSRSR+GR

Check all that apply:
New to InterVarsity
International student

How interested are you in a small group Bible study?
(1 = not at all, 10 = Yes, definitely!)

12345678910

How excited are you about impacting U of I with your faith?
(1 = not at all, 10 = Yes, definitely!)

12345678910

Social Media Handles

Which way(s) would you prefer to be contacted by another student in your area?
TextEmailInstagramSnapchatFacebook messengerPhone callIn person

Comments or questions: