Please print, complete, send/deliver to WSC Registrar Office in Hahn. Tks! J
	STUDENT AGREEMENT FOR RELEASE OF RELIGIOUS PREFERENCE INFORMATION TO APPROPRIATE RELIGIOUS ORGANIZATION(S)
	I hereby authorize the release of my religious preference on file at Wayne State College to the appropriate religious organization(s) if requested. I authorize the release of my name and mailing address to the organization affiliated with my religious preference. I understand this release applies to all periods of enrollment at WSC unless I submit a specific written request for this authorization to be rescinded.
	Name (please print):____________________________________________________________ Student I.D. # (will not be released--for office use only):_________________________________ Signature:______________________________________ Date:____________________ Please check one below:
	___Assembly of God	___ Episcopal	___ Mennonite
	___ Baptist	___ Greek Orthodox	___ Methodist – United
	___ Catholic	___ Islamic/Muslim	___ Methodist - Wesleyan
	___ Church of Christ	___ Jehovah Witnesses	___ Mormon
	___ Congregational	___ Jewish	___ Native American
	___ Covenant	___ Lutheran	___ Presbyterian
	___ Disciples of Christ	___ Lutheran - ELCA	___ United Church of Christ
	___ Evangelical Free	___ Lutheran - Missouri	___ Other: ______________
	Office of Records & Registration, WSC, 375-7241
	04/26/04 …08/20/07
	Go back to Catholic Newman ~ Go back to CoopCM