Registration for the Spring College Retreat
April 4-5, 2009

We're so glad you can join us for our Spring Retreat!  Now it's time to get some info about you!

First Name
Last Name
School (if applicable)
Local Address
Town ZIP
Email Address
Phone Number

I am interested in receiving a scholarship.

I am interested in donating $5.00 to the scholarship fund.

I prefer vegetarian meals.

Anything else you would like us to know?  (Medical conditions, special circumstances, etc.)