Evensong by the Sea
Retreat & Spirituality Center
326 Lower County Road
Harwich Port, MA 02646

TO APPLY BY MAIL FOR A RETREAT
PRINT THIS PAGE AND FILL
OUT THE FORM BELOW:

+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

Please send to: Evensong Retreat & Spirituality Center,
326 Lower County Road
Harwich Port, MA 02646
508.432.0027     info@evensongretreat.com     www.evensongretreat.com
(To fax this form to us please call us for our fax number.)

Evensong by the Sea
Ecumenical Retreat & Spirituality Center
Retreat Application Form

Please indicate the type of retreat you wish to apply for:

___ Guided Weekend Retreat: Title:_________________ Date of Retreat:______________

___ Reiki Training on the following dates:_______________________________________

___ Individual Private retreat on the following dates: ______________________________

___ Five Day Retreat on the following dates: ____________________________________

___ Eight Day Retreat on the following dates: ____________________________________

___ Thirty Day Retreat on the following dates: ___________________________________

Personal Information:

Name____________________________________________ Age (Optional)____ Gender:___
First Middle Ini. Last

Address:___________________________ City:______________________State___Zip_____

Phone numbers:____________________ ___________________ ______________________
Work Home Cell

Email Address:___________________________________ Marital Status:________________

Religious Affiliation:_______________________________

Any Food Restrictions? ______(If yes please specify in space below)

 

 

For Retreatants staying five days or longer please list a person to contact in case of emergency:

Name:______________________________Phone:____________________

Address:______________________________________________________
Street City State

Please check all that apply:

___ Member of a Religious Order ____ Clergy _____Layperson

___ Involved in Ministry (please specify):___________________________________

___ Currently have a Spiritual Director ___ Have never been in Spiritual Direction

___ Have been in Spiritual Direction in past for____________(specify length of time)

While on retreat I would like _____Spiritual Direction ____ A Reiki Treatment
(Spiritual Direction is a part of Five, Eight, and Thirty Day Retreats; Spiritual Direction for individual private
retreats, and Reiki Treatments involve additional fees)

(Over, Please)

 

Please answer each question below that applies. (Feel free to use additional sheets if necessary.)

 

1. Please list your retreat experiences over the past five years. Include the type and location of retreat.

 

 

 

 

 

2. How have your retreats impacted your spiritual journey?

 

 

 

 

 

 

3. What is your level of comfort with silence on your retreat experiences?

 

 

 

 

 

4. [For those applying for individual private retreats only:] Please write a brief paragraph describing what you seek on this retreat.

 

 

 

 

 

 

 

 

 

 

5. [For those applying for Five-day or Eight-Day retreats only:] Please write 1 - 2 pages describing where you are on your spiritual journey, and what you hope for on this retreat.

 

6. [For those applying for Thirty Day Retreats only:] Please write 2 - 3 pages giving an overview of your spiritual journey to date. Conclude with two or three paragraphs explaining what moves you to make a thirty-day retreat at this time, and what you seek on this retreat. Also, please include with your application a letter of reference from your spiritual director or your pastor.

**************************************************

Please return this form, along with your non-refundable deposit fee (50% of total) to the address below. (Information on retreat costs and deposit fees may be obtained on our website or by calling us. You may use a credit card for your deposit by calling us after you mail your application.) Make checks payable to Evensong Retreat Center. Your retreat space will be confirmed via email. Send application to:

Evensong by the Sea
Ecumenical Retreat & Spirituality Center
326 Lower County Road
Harwich Port, MA 02646-1625
508-432-0027 / www.evensongretreat.com / info@evensongretreat.com