Application For Special Programs

St. Joseph Retreat Center 339 Jerusalem Road, Cohasset, MA 02025 781-383-6024 781-383-6029 retreat@csjretreatcenter.org www.csjretreatcenter.org Application For Special Programs Please fill in ALL requested information. Please enter N/A for Not Applicable where necessary. Important: In order for us to serve you via email, please put the following address in your email address book now: Retreat.Center@csjboston.org If you do not receive a reply from us because we are not in your address book, the reply was placed into your spam folder by your email program. I have read and responded to this request. (Type: "Yes")
Retreat Dates Available: Retreat Dates Selected:
Name:
Address Street:
Address City: State: Zip:
Address Province: Country:
Telephone: Home: Work: Cell:
1. E-Mail Address : 2. Retype E-Mail Address :
Mailing Information: ....Updated Address: ....New Address: .... First Registration:
Contact person in case of emergency: Name: Telephone: Home: Work: Cell:
The chapel is on the second floor, accessible only by stairs. Please mention any special health/dietary needs you have.
Please do not send any money until you receive confirmation of your acceptance. Your non-refundable, non-transferable deposit of 20% will be due within 10 after you have received your confirmation of acceptance. Please make checks payable to St. Joseph Retreat Center. OFFICE HOURS: MONDAY TO FRIDAY, 9:00 A.M. -5:00 P.M.