| Personal Information |
|
| Last Name |
|
First Names
His |
|
| Hers |
|
| Address |
|
| City |
|
| Province / State |
e.g. NY |
| Postal Code / Zip Code |
e.g. 123456 |
| Wedding Date |
yyyy-mm-dd |
| Church currently attending |
|
| E-mail Address |
|
| Home Phone |
|
| Cell Phone |
|
| Work Phone |
|
| Recommended by |
(couple who attended a weekend) |
| Weekend Options |
|
| Date/Location |
|
| Can attend |
on
short notice or not |
| His Physical Needs |
|
| Her Physical Needs |
|
| Room Choice |
no
smoking smoking |
| Dietary Needs |
|
| Application Fee ($50) |
cheque
credit card |
If paying by credit card, please call Harold & Diane
(listed below) with credit card number and expiration date or pay online
using PayPal when prompted. To pay by check, make checks payable to Covenant
Encounters then address your envelope to Harold & Diane Westerman,
2086 Nash Rd, Bowmanville, ON, L1C 3K4, 905-623-7147,
finance_canada@reformedme.org
|
|
For all questions regarding your weekend, contact David and Danielle Stell, 905-985-8305,
ontario_registration@reformedme.org
|
