Miramar Retreat Center
Directed Retreat Reservation Form
Requested Retreat Date: (mm/dd/yyyy) (REQUIRED)
Would you like to be placed on a waiting list if the retreat is full?
Yes
No
 
Is this a New Address: Yes No
Birth Year: (yyyy)
Name:
Address:
City:
State:
Zip:
Telephone:
 
Cell Phone:
   
Email:
   
Religious:  Yes   No
Married:  Yes  No    
Priest: Yes  No    
Number of Years:
Single:  Yes  No    
Congregation:
   
Do You need a first floor room?  Yes:  No:  
Emergency Contact:
 
Telephone:
   
Do you have a preference for a director? Yes:   No:   Male:  Female:
(We cannot guarantee we will fulfill your preference, but we will do our best).
Have you made a directed retreat before?
Yes:  No:
 
How Recently:
   
Are you presently in spiritual direction?  Yes:  No:    
If no, have you ever been in spiritual direction?  Yes   No    
Recent living conditions:
   
Current work ministry:
   
Health Needs:
   
Reasons/goals for making retreat:
   

1. SUBMIT RESERVATION form:
(Click Submit Reservation Button Below)
 
2009 DIRECTED RETREATS
   
   

 January 2-9, 2009 ( 7 nights)

May 17-22, 2009 ( 5 nights)

June 21-28, 2009 ( 7 nights)

July 12-19, 2009 ( 7 nights)

August 2-9, 2009 ( 7 nights)

   
   
     ( Please click Submit Reservation NOW before making payment below.)
 

2. MAKE PAYMENT: 7 - NIGHT DIRECTED RETREAT
 
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Full Payment Cost: $455.00
Make Full Payment Now

Non Refundable Deposit $100.00
Make Non-Refundable Deposit Now

2. MAKE PAYMENT: 5 - NIGHT DIRECTED RETREAT
 
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Full Payment Cost: $325.00
Make Full Payment Now

Non Refundable Deposit $75.00
Make Non-Refundable Deposit Now

   

 

If your application and deposit have been received and rooms are still available, we will make a reservation.
Otherwise, we will contact you to consider another date or your payment will be refunded.

FOR MORE INFORMATION
CALL: (781) 585-2460
FAX: (781) 585-3770
E-MAIL: miramarma@aol.com

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