Invitation Form for Receiving Parish

This information can be used to create a paper or electronic registration form.

Church Name

Address

Phone, Fax

Complete this form and return it to the Parish Office

Retreat Date Desired- circle one

Date Here or      Date Here 6 months later Men’s Retreat

Date Here or      Date Here 6 months later Women’s Retreat

First Name:

Last Name:

Nickname (for Nametag):

Street Address:

City/State/Zip:

Home Phone:

Email Address:

Are you a registered member of the parish? No Yes

Do you have food allergies or special dietary needs? _________________________________

Do you require any special accommodations? ______________________________________

Contacts

Full Name:                                                                          Full Name:

Relative:                                                                              Friend:

Phone Number:                                                                Phone Number:

Email:                                                                                  Email:

Questions or Comments:

Office Use:

Date/Time Rec’d.________ # for desired retreat____

Confirmed date______ By_____ Confirm Letter_____