Application for Upper Room Retreat

Please fill out this application to attend the Upper Room Retreat. Note that this retreat is "by invitation only." A member of our ministry team will contact you to confirm your acceptance into the program. Please do not purchase any plane tickets until you have been contacted by a member of The Ark and The Dove staff.

Full Name(Requirido)

Nome Sobrenome

E-mail(Requirido)

Digite um e-mail Confirmar e-mail

telefone(Requirido)

Endereço(Requirido)

Rua Bairro e Complemento Cidade Estado Código postal País

Please tell us how you heard about this Upper Room Retreat! (Include any information about which memember of our Board of Directors shared the invitation with you.)(Requirido)

Please tell us about your involvement in the Catholic Charismatic Renewal(Requirido)

Have you been to The Ark and The Dove previously?(Requirido)

sim

Não

Is there anything else you would like us to know?

Please note that this form is an application only. Once you complete this form, a member of The Ark and The Dove staff will contact you via email regarding your attendance for the retreat. Please do not purchase any plane tickets until we have contacted you. Thank you! You will be contacted within two weeks of submitting this initial application.

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