Pen Pal Directory Application

The SKY Connections Directory is a way for Sabbath Keeping Youth
to get connected. To be apart of it, print and fill out the form. Have
your parents sign the consent form and return it to the address below.
It cannot be e-mailed in. All the information will be used in the latest
directory and you will be sent a SKY Connection Directory. Get to know
other Sabbath Keeping Youth around the world!
Mail to:
The Church of God, International, ATTN: Youth Program Dept., 22525 State Hwy 155 S, Flint, TX 75762

Fill in the Directory Information:

First name:                                     Middle:                                     Last:
___________________________________________________________________________________

Address/P.O. Box:                                                                              Apt No.:
___________________________________________________________________________________

City:                                                     State/Province:                         Zip/Postal code:
___________________________________________________________________________________

Country:                                                     Email Address:
___________________________________________________________________________________

Telephone Number:                         Birth Date:                                                 Gender (circle one):
______-________-________             ______/_______/______                                     M       F
                                                            month      day       year

Interests, hobbies, and goals: ___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

Parental Consent:

I am the parent/legal guardian of the child whose name appears above. By signing this form, I acknowledge The Church of God, International has my permission to publish the above information in the SKY Connections Directory.

__________________________________________________________
Parent/legal guardian signature

___________________
Date