Retreat Information Form

* Denotes Required Field

Church/Group Information
Church/Group Name	*
Phone Number	*
Church Email Address
Date of Event	*
Address	*
City	*
State	*
Zip	*
Event Location and address (if different than church address)
Time retreat will begin	*
Time retreat will end	*
Event Coordinator Information
Coordinator's Phone (home or work and cell)
When is the best time to reach you?	*
Coordinator's Email	*
Retreat Information
Number of expected participants	*
How do you plan to promote this event?	*
What type of technical assistance will be provided? (microphone, audio recording, power point, etc.)	*
Give a brief description of your church and the women in your ministry. Provide details such as Christ-followers or seekers, median age, worship style, etc.
Prayer Information
What are you and your event team praying for God to accomplish through this retreat?
How can the Reflecting Grace Ministry Team pray for you and your team?	*
Other Information
Regarding	*
Comments/Questions