Form – KIT | Immanuel Lutheran Church and School

Recipient's Name*

First Last

College/University or Military Service?

Recipient's Mailing Address (at school or military base)*

Street Address Address Line 2 City State ZIP Code

Recipient's Email*

GIFT CARDS AND NOTES WILL BE SENT TO THIS EMAIL ADDRESS

Recipient's Cell Phone

Recipient's Birthday*

Branch of Military Service*

Military Rank*

College or University*

City*

Year

Major*

Minor (if any)

Anticipated Graduation Year

Plans after Graduation/Military Service

Connection to Immanuel Lutheran Church and School?*

Church Membership (if any)

Parent's Name*

First Last

Parent's Email Address*

Parent's Phone*

Preferred Restaurant/Store Gift Card(s)