ADDRESS ___________________________________________________________________________
CITY __________________________________________ STATE _______ ZIP __________
PHONE ______________________________ DATE OF BIRTH ________________ AGE _______
SCHOOL ___________________________________________ GRADE _______________
PARISH ________________________________________________
DATE OF WEEKEND YOU ARE APPLYING FOR: ____________________________________
PARENTS NAMES____________________________________________ WORK PHONE___________
______________________________________________________________ WORK PHONE___________
PARENTS' E-MAIL ADDRESSES _____________________________________________
PARENTS ADDRESS IF DIFFERENT FROM ABOVE: _________________________________
HAVE YOU EVER BEEN ON A WEEKEND RETREAT? _______
IF SO. WHICH ONES? __________________________________________________
LIST ANY CHURCH/SCHOOL ACTIVITIES WHICH YOU ARE INVOLVED IN:
_____________________________________________________________________________________________
LIST YOUR HOBBIES. INTERESTS, TALENTS ________________________________________________
JOURNEY SPONSOR'S NAME _____________________________________ PHONE ____________
HAS YOUR SPONSOR EXPLAINED TO YOU WHAT THE JOURNEY EXPERIENCE IS ABOUT AND ANSWERED YOUR QUESTIONS ABOUT THE WEEKEND? _________
HAS YOUR SPONSOR INFORMED YOU THAT THE WEEKEND BEGINS ON THURSDAY EVENING AT 7 P.M. AND ENDS ON SUNDAY EVENING, AND THAT YOUR COMMITMENT TO THE JOURNEY EXPERIENCE IS FOR THAT PERIOD OF TIME? ________
ON THE BACK OF THIS APPLICATION, PLEASE WRITE A BRIEF EXPLANATION OF WHY YOU WOULD LIKE TO PARTICIPATE IN THE JOURNEY EXPERIENCE AND WHAT YOU HOPE TO GAIN FROM IT.
SIGNED __________________________________________ DATE ____________
PLEASE SEND THIS COMPLETED APPLICATION WITH YOUR PAYMENT OF $100.00 TO:
MR. MARK SABATINI, 1847 FERGUSON ST., SCHENECTADY, NY 12303
MAKE CHECKS PAYABLE TO THE JOURNEY RETREAT PROGRAM