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CAMPUS MINISTRY
 
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Office of Campus Ministry
Administration Building 101A
on Drexel Drive
 
Campus Ministry Retreat sign-up
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Campus Ministry Everybody's Retreat: March 7-9, 2008
Please take the time to fill out the form below completely. We appreciate your interest and look forward to making this retreat a wonderful learning experience for everyone.

The retreat cost is $20 per person. You will receive a confirmation after you submit this form, then you will be asked to pay your retreat fee at the Campus Ministry office.

If you have any questions or comments contact Campus Ministry office by emailing your question here or by calling x7593.

Personal / Contact Information
Name:
Phone:
 Email Address:
Class Year:
 Religious Affiliation:
Hometown:
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Residents On Campus
Residence Hall:
 Room Number:
Residents Off Campus
Street Address:
City:
 State, Zip:
,
Emergency Contact Information:
Name:
 Phone Number:
Relation to You:
Other Information
List Any Special Needs:
Medical Conditions and/or Medications:
Dietary Restrictions:
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