Name

Address

City,State,Zip

Best Phone to Reach You

Email

Title (or type) of and Dates of Retreat
(Type in "Individual Private Retreat" if you are looking to come on a retreat by yourself)

Arrival Date Departure Date

[Please note: Private individual retreats may be scheduled for 2 days or more
between Tuesday at 1pm and Sunday at 11am]

Please place a checkmark in the box next to the lines that apply:

I have been on retreats before

I am comfortable with silent retreats

I currently have a spiritual director

Please explain briefly what you hope to gain from this retreat

When you have completed the above please click on submit. A 50% non-refundable deposit is required
to reserve retreat dates. Someone from Evensong will contact you to process your application
and arrange for your deposit. We accept personal checks, Master Card, Visa, or Discover.