2020 Spring 5-Day Silent Retreat at Mother Cabrini Shrine (optional 4 or 3-Days) | Application
Instructions for completing application:

    * Please submit a 50% deposit with your application - Indicate on the MEMO line of your check that the
       payment is for the Spring 2020 Silent Retreats at Mother Cabrini Shrine

    * All applications will be reviewed by a staff member of the Lanteri Center    

    * Refunds will be issued for those whose applications are not accepted at this time

Please return your application and deposit to:
Lanteri Center for Ignatian Spirituality , 416 22nd Street, Denver, CO 80205  
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Location: Mother Cabrini Shrine
Check in is before 5 pm for orientation, schedule review and room assignment. Please make every effort to stay through the end of the retreat on Sunday afternoon
Retreat Length: *
Personal Contact Information
Applicant's Name: *
Applicant's Email Address: *
Applicant's Mailing Address: *
Applicant's Telephone: *
Emergency Contact Information
Emergency Contact Name: *
Emergency Contact Relationship: *
Emergency Contact Phone Number: *
For a Better Appreciation of Your Personal Spirituality
[All this information will be kept confidential]
Have you made a silent retreat before? *
Was it personally directed or guided? *
Are you currently in spiritual direction? *
What prompts you to make this retreat? *
What desires, expectations, hopes, fears or concerns do you have for this retreat? *
What have been some of the major influences affecting your personal life/spirituality? And how have they affected you? (Example: Parents/Family) *
Favorite/Scripture/Passages: *
 Moments of major decisions (Vocation/Change/Conflict) Conversion Experiences: *
What is your present ministry/occupation *
Religious Affiliation *
Required
Check One: *
Date of Birth: *
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What Parish do you attend? *
Medical Information Section
Are there any past or current medical conditions or information that we need to be aware of? *
Are there allergic conditions that we need to be aware of? (Including medication allergies): *
Do you currently take medications? If yes, please list medications: *
Will you have any special needs during this retreat? If yes, please explain: *
Do you have medical background/training? If yes, please explain: *
Alternate Emergency Contact Name & Phone Number: *
Health Insurance Company: *
Health Insurance Phone Number: *
Policy Holder Name: *
Group Number: *
Date of Application: *
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Signature: *
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