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 Registration Fee

Course Selection & Registration Fee*

$ 40.00 -[ EMMAUS -Journey to Discipleship ] -Belleville (-20 to 22 Jan. 2023 )

Payment Options: *

eTransfer to: kimberly.long@sympatico.ca

Cheque (payable to: SASE -Belleville)

Cash

Payment Options: eTransfer: -if you have chosen an eTransfer payment option, please don't forget to execute the eTransfer action with your respective bank.

Is billeting desired?

YES billeting is desired!

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 a local registrant, and could provide a billeting service, that is always appreciated! Please advise in the [ Billeting Comments ] how you might be able to assist in this ministry (a spare room, # of beds, etc.). Thank-you so much!

Billeting Comments

Any closing comments?

"emmaus" -Belleville, on: 20 - 22 JANUARY 2023