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Let's Celebrate the Class of 2011!
Wednesday, June 8th ** 7pm

If you are graduating from High School this year, please fill out the questionnaire below to be included in the graduation celebration on Wednesday night, June 8th in the Kairos Youth Service.

Graduate’s Full Name: 

Date of Birth:  


Family & Contact Info:

  1. Parent’s Names: 
  2. Siblings Names/Ages: 
  3. Student Email address: 
  4. Parent Email address: 
  5. Funny “school” story about Graduate as a child:

Word of Life (Kairos) Connection:

  1. How long have you been a part of the Word of Life (Kairos Youth) family? 
  2. What church activities & events have you participated in or awards have you received? 
  3. What is your favorite moment at Word of Life or as a part of the Youth Ministry?

High School Info:

  1. Name of your high school: 
  2. GPA:    Awards & Honors: 
  3. Activities, Clubs, & Sports teams participation/awards: 

Future Dreams and Plans:

  1. What will you be doing this summer? this fall? 
  2. What goals do you have for your life...
    In 5 years: 
    In 10 years: