Christian Awakening Retreat 
November 7th, 8th, & 9th
    
Sponsored by: 
Catholic Campus Ministry 
847 South Holland Avenue
Springfield MO 65806
Phone - 417-865-0802

For more information about Awakening, click here.

Please Complete the Entry Form below completely.
 Do not use the Enter Key, but use the Tab key to move to the next field.
Then press the "Enroll me." button at the bottom of the form.


    

Name:                          School: 

Mailing Address:     

City,  State,  Zip         

Phone:                   E-Mail 

Parent's Name:      Parent's Phone: 

Parent's Address:   City, State, Zip   

T-Shirt Size  (Small,  Medium,  Large,  Extra Large) 

How you heard about our retreat?

In the following field, please include any food allergies or special needs we should take into consideration for the weekend.

Make Check of $25.00  payable to  Catholic Campus Ministry,  (Please indicate on your check:  "e-mail registration")

 and mail to:       Catholic Campus Ministry 
                           847 South Holland Avenue  
                           Springfield, MO  65806-3513. 


Your Entry Form is being sent to the Awakening Retreat Coordinator 
at Catholic Campus Ministry.