*Required Enter the starting date of the retreat you are applying for: Example: December 17, 2012 *
Personal:
First:
Last:		Jr, SJ, etc:
Gender:	Male     Female
Year of Birth :
Contact Info:
Number and Street:
City/Town:
State/Province/Country:		Zip Code:
Home telephone:
Work telephone:
Fax:
Email:
Other:
Religious Denomination:
Marital Status:
Check all that apply:	Relig Sister or Brother Relig Priest Dioc Priest Perm Deacon	Seminarian Clergy of another denomination Layperson
Is this your first retreat at Eastern Point Retreat House:
Present Occupation/Ministry:
In case of an Emergency: (The contact person may not be someone who is on this retreat with you.)
Name:
Home Phone:
Work Phone:
PLEASE BE SURE TO COMPLETE THE FOLLOWING QUESTIONS:
To help us in processing your application, in selecting a director, and for the benefit of your director, PLEASE answer the following questions in some detail.  Every application must be accompanied by the following information in order to have it considered.
List your retreat experience for the past 3-4 years, including the type of retreat (e.g., guided, individually directed, weekend, etc.) with the location and year. If you are presently involved in regular spiritual direction, how often do you meet with your director? What are your hopes and expectations for this retreat? How have your most recent retreats, if any, impacted your life? How comfortable are you with maintaining silence during your retreat? For those applying for directed retreats: Are there any characteristics or qualities that you seek in a director? Feel free to indicate a preference for a director. Please note: we do not offer in advance any guarantee regarding who will be assigned as your director. List any health concerns, special needs (e.g., accessibility, first floor), or dietary allergies, (e.g., shellfish, peanuts, milk) that we should be aware of.
Please plan to arrive BETWEEN 3:00 PM AND 6:00 PM. This enables the staff to prepare your room and for you to settle in with your luggage. Dinner is at 6:00 pm. General meeting is at 7:30 pm. Please note: We can not guarantee your preference for a particular director. PLEASE DO NOT SEND MONEY NOW. Canadian Citizens are reminded the payment is best made by means of United States currency or, incur a fee of $15 for bank processing. You will hear back from us soon after this preliminary application has been processed.