Inside Perkins Registration Form

Please complete this form to register for a session of Inside Perkins:

Last Name

First Name

Address 1

Address 2

City

State

Postal Code

Home Phone

Work Phone

Other Phone

Date of birth

Gender

Female
Male

Denomination

Annual Conference (if UMC)

Are you a college graduate?

Yes
No

College/University

Degree

Date of Graduation

Citizenship

Is this a second career for you?

Yes
No

Degree Interest

Campus

Dallas
Houston/Galveston

Expected Enrollment Date

Inisde Perkins Event Date

Will you need guest housing?

Yes
No

Arrival day:

Arrival time:

Will you need transportation to/from airport?

Yes
No
Flight information pending

If yes, arrival/departure information

Will a guest be joining you? ($25 per Dallas guest)

Yes
No

Guest's name

Dietary or other special needs:

Would you like us to send you an admissions packet?

Yes
No

Ethnicity:

Providing ethnicity information is voluntary. The information you choose to provide will be used in a nondiscriminatory manner, consistent with applicable civil rights laws, solely for required reporting under federal and/or state laws.

Special questions or concerns

(511 character maximum)Please submit longer messages by email to theology@smu.edu.