First Name:
Middle Name:
Last Name:
Email:
Cell Phone #:
T-Shirt size:
S
M
L
XL
XXL
Home Address:
Home Phone:
University:
Grade classification:
Freshman
Sophomore
Junior
Senior
Graduate
Alumni
Expected graduation year:
Major:
Birthday:
Hometown:
Home Parish:
Home Diocese:
Emergency Contact:
(not a college friend)
Relationship to Emergency Contact:
Mother
Father
Legal Guardian
Other
Emergency Contact Phone Number:
Emergency Contact Email:
Comments:
(Please list any dietary restrictions including vegetarian or vegan. Please list any special accommodations or needs)
Other Information
Favorite Color:
Activities/Organizations:
Favorite Bible Verse:
Favorite Saint:
Favorite Prayer:
Who inspires you and why:
What do you hope to get out of this retreat:
Who do you want to be?:
How do you best connect with God?:
Rate your relationship with God:
(1=distant, 10=He's my best friend)
1
2
3
4
5
6
7
8
9
10
How do you de-stress?:
What are some of the gifts that God has given you?:
Free Write:
(What else do you feel we should know about you that we haven't asked about?)
Financial Need:
(If yes, please explain)
I have applied for
Boiler Awakening before:
I am Catholic:
I am Baptized:
I am Married:
May we use this information
to register you for the parish?:
Yes
No
May we use this information
to register you on FlockNote?:
Yes
No