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Adopt a Duke (Blessed Buddies): Student Form
If you are interested in having a home away from home in Harrisonburg, please fill out this form and we will pair you with a community member. If you have any questions, feel free to reach out to the CCM Hospitality Chair at
jmuccmsocial@gmail.com
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Name
Your answer
Mailing Address
Your answer
Phone
Your answer
Email
Your answer
Major
Your answer
Expected Grad Year
Your answer
Birthday
MM
/
DD
/
YYYY
Year
Freshman
Sophomore
Junior
Senior
Grad Student
Clear selection
Current CCM Activities you are involved in
Your answer
Current JMU Activities you are involved in
Your answer
Tell us about yourself! (Hobbies, interests, career, home origin, etc)
Your answer
Any Special dietary requirements or restrictions?
Your answer
Will you need transportation?
Yes
No
Clear selection
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 you can't go home)
I prefer just phone, text, email, and receive prayer support for now
Other:
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