St. Andrew School of Evangelization - Emmaus | St.Andrew School of Evangelization -SASE

Title*

First Name*

Last Name*

Address

Address 2

City*

Province / State*

Postal Code / Zip*

Email Address*

Phone*

Alternate Phone number*

What diocese are you from? (drop-down list).*

If "Other", please specify

What parish or church do you attend? *

EMERGENCY CONTACT DATA

Emergency Contact Name*

Contact Phone *

Contact Relationship*

Course Selection and Suggested Registration Donation

Course Selection & Suggest Registration Donation*

$50 -[ EMMAUS - ] -Belleville (-25Oct.2019- )

-{ Is billeting desired? } If 'YES' please check.

Payment Options: *

Cheque (payable to: SASE -Belleville)

Cash

DIETARY CONSIDERATIONS: due to ever increasing dietary restrictions requests, and the volunteer nature of the food ministry, meeting these increasing demands has become unmanageable. As such, if you have specific dietary needs, we request that you bring your own food, and it can be safely stored for you at the facility. This has often been done by many course participants.

Special Considerations? Aroma, chemical, mobility

Aroma sensitive

Mobility challenges

BILLETING: if you are local, and could provide a billeting service, that is always appreciated! Please advise in the [ Billeting Comments ] how you may be able to assist in this ministry. Thank-you so much!

Billeting Comments

Any closing comments?