Journey Retreat Program
Online Application Form
You can now apply for the next Journey Retreat by completing this form and clicking the "Send Application" button. Complete all boxes that apply to you. After you send in an application, you will receive an e-mail confirming your application. If you do not receive a confirming e-mail, please contact us. The cost of the Journey Retreat Weekend is $100.00
Thank you for using our on-line form.
Your Name:
 Your Date of Birth:
Your street address:
 City, State, Zip:
Your e-mail address:
 Your phone number
Your Parish:
 Your School: and Grade (9th, 10th, 11th, or 12th)
Name of a Parent:
 Work Phone of Parent
Name of other Parent (if applicable):
 Work Phone of Parent
Address of Parent if different from yours:
 Your Parent's e-mail address:
What Retreats have you attended?: (if any)
 Date of Journey for which you are applying:

List any Church or School Activities
in which you are involved.

List your hobbies, interests, talents
Name of Your Journey Sponsor:
 Phone of Journey Sponsor
Has your sponsor explained to you what the Journey Weekend is about and
answered your questions about the Journey Weekend?
     YES or NO
Has your sponsor informed you that the Journey Weekend begins on Thursday evening at 7:30 pm and ends on Sunday              evening, and your commitment to the Journey Experience is for that period of time?
      YES or NO
Please write a brief explanation of why you would like to participate
in the Journey Experience and what you hope to gain from it.
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