IMPACT Campus Ministry Interest Form

FAMU Email / TCC Email / FSU Email (Personal email if you are not a student)

This address will receive a confirmation email

FAMU Student ID

Name

Personal Cell Phone Number

IMPACT Involvement

Student Member Community Member Board of Directors Donor

Classification

Major

Mailing Address

Birthdate

Gender

Female (Cis or Trans) Male (Cis or Trans) Non-Binary

How would you like to be identified ?

Shirt Size

X-Small Small Medium Large XL- Extra Large XXL - Extra extra Large

Shirt Receipt

I have an IMPACT shirt I need an IMPACT shirt

We want to partner with you in every way to ensure we are inspiring your whole self. For the work we do to prosper, those who receive from us must reciprocate in giving.

The following list is not exhaustive, but represents many of the leadership opportunities available to students who feel a calling to serve within the ministry of IMPACT @ FAMU Wesley. It is our hope and prayer that your time at IMPACT @ FAMU Wesley will be one where you grow and are challenged as a leader.

If Not Sure/Other, please list below

Monetary Commitment

As a student member, I will give at least $10 a month or $100 a year to the ministry positively impacting me, FAMU and the community. As a community member, I will give at least $20 a month or $200 a year to the ministry positively impacting FAMU and the community.. As a member of the Board of Directors of the FAMU Wesley Foundation, I will give at least $50 a month or $500 a year to the ministry positively impacting FAMU and the community.

IMPACT Campus Ministry Interest Form

Description

Please Fix the Following