If you are a member of the clergy, please click here for your application form.

PLEASE NOTE: Recent parish bulletin announcements included a Weekend scheduled for Feb 24-26 in Atlantic Beach, NC. This is incorrect. We sincerely apologize for the confusion.

Weekend Selections:

1st Choice Apr 27-29, 2012 [ Winston-Salem, NC ] Jun 22-24, 2012 [ Raleigh, NC ] Sep 21-23, 2012 [ Hickory, NC ] Nov 2-4, 2012 [ Atlantic Beach, NC ]

 

2nd Choice Apr 27-29, 2012 [ Winston-Salem, NC ] Jun 22-24, 2012 [ Raleigh, NC ] Sep 21-23, 2012 [ Hickory, NC ] Nov 2-4, 2012 [ Atlantic Beach, NC ]

Preferred Names (for name tags)

Husband's first name: Wife's first name: Last name: Wife's last name: (if different)

Contact Information

Street address: Street address (cont.): City: State/Province: Postal code: (USA or Canada) Primary email: Alternate email: Primary phone: Alternate phone:

Faith Preferences:

Husband's faith: Husband's parish/church: Wife's faith: Wife's parish/church:

Additional Information

Wedding date: (MM/DD/YYYY) Previously Encountered: Please choose... Yes, we have been on a Weekend before. No, this will be our first WWME Weekend. Referred By: Phone: How did you find us? (please check all that apply)
Advertising - Internet Ad
Advertising - Printed Ad
Advertising - Radio
Church bulletin
Family Counselor
Friends or Family
Info night/Dinner
Internet Search
Other
Previously Encountered
Priest/Pastor
Pulpit Inviting Talks
Relative/Family
Website/Internet
WWME Brochure

Husband dietary requirements: Wife dietary requirements: Additional needs and/or requests: Hotel room preference: (All retreat centers are non-smoking) Please choose... We would prefer a smoking room.. We would prefer a NON-smoking room.

Application Fee Payment: Please choose... Personal check/Money order PayPal or Credit Card

You do not need a PayPal account to pay by   credit card or electronic check. See payment instructions below.

Discount code:

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