FBC Women's Retreat 2010 April 30-May 1 Survey

Please fill out the following: Name:
Address:
City/Town:
State:
ZIP/Postal Code:
Email Address:
Phone Number:

To request a specific roommate, put her name here:

Would you be interested in giving a donation to help another woman (e.x. a college student) be able to attend the retreat? Yes

No

If yes, please write the amount which you would like to give:

Please choose one of the following: I will be attending... (A) The whole retreat; cost $75 (includes 3 meals & lodging)

(B) Friday only; cost $25

(C) Saturday only; cost $25

Extra Information: Yes, I want to participate in the horseback riding that will be an additional cost and take place at 2:30PM Saturday.

Yes, I want to ride in the church van that will leave Friday, April 30 at 5:30 PM and return Saturday, May 1st at 4PM.

FBC Women's Retreat 2010 April 30-May 1
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