(ADOPTER FORM)

Blessed Sacrament Catholic Church

“Blessed Buddies” Application

Name(s):______

Mailing Address: ______

Phone:______E-mail: ______

If family, name of primary contact: ______M F Cell: ______

Preferred form of communication:  Phone  Email  Text Facebook

Ages:  20-35  36-55 56+ If Children, Ages: ______

Number of CCM students you would like to adopt (ideally 2 or more): ______

Would you prefer male or female students (we will try our best to accommodate): M F

Tell us about yourself! Any “bio” information that would be helpful in matching you with a student Buddies! (family, career field & history, passions,home origin, hobbies, interests, etc.):

______

What would you offer a Catholic JMU student Buddy?(mark as many as you like)

Family  CoupleIndividual

 Occasional dinner together Occasional meets for coffee/lunch

 Visiting local places of interest Attending Mass together

 Shopping/Transportation Holidays (if students can’t go home)

 Other: ______

Comments and/or suggestions you have regarding this ministry and your family(eg. Once a semester, all families & students get together):

______

______

JMU Catholic Campus Ministry

“Blessed Buddies” Application

Name(s): ______

Mailing Address: ______

Phone: ______E-mail: ______

Major: ______Expected Grad Year: ______

Birth Date: ______ Freshman  Sophomore  Junior  Senior  Grad Student

Current CCM Activities you are involved in: ______

______

Current JMU Activities you are involved in: ______

______

Tell us about yourself! Any “bio” information that would be helpful in matching you with a Blessed Sacrament family (hobbies, interests, career, home origin, etc.):

______

Any special dietary requirements?: ______

Will you need transportation?: ______

What would you like from a Parish Family?(mark as many as you like)

 Family  Couple Individual

 Occasional dinner together Occasional meets for coffee/lunch

 Visiting local places of interest Attending Mass together

 Shopping/Transportation Holidays (if students can’t go home)

 Other: ______

 I prefer just phone, text, email and receive prayer support for now

Please return this form to Donna Lou Shickel at Blessed Sacrament Catholic Church
or Erica Panasiewicz at Catholic Campus Ministry.

Donna Lou: or Erica: