Retreat Intake Form

Redirecting you to a secure payment page…

Retreat Intake form

First Name *

Last Name *

Prefix *

Gender *

Email *

Phone *

Home Address *

City *

State *

Zip *

Parish Name AND City *

How did you hear about Bethany Center for Prayer and Renewal? *

Please give the full name of who referred you.

What is your desired retreat length? *

3 Days

5 Days

8 Days

Other

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

In order to provide you with the most meaningful and supportive retreat experience possible, we invite you to share thoughtful and detailed insights into your spiritual journey. This intake process is essential, as your honesty and depth of sharing will help us facilitate an environment where our Lord can work most fruitfully in your life. Rest assured that all information you disclose will be treated with the utmost confidentiality and respect.

Are you a practicing Catholic? *

Yes

If no, please describe your faith background and practice.

Describe your current relationship with God and your prayer life. How frequently do you pray? What does your prayer typically look like? *

Why do you feel drawn to make a silent, directed retreat? *

Have you ever been on a silent retreat, either directed or not? *

Yes

If yes, please describe your retreat experience and the length of retreat.

Do you experience any emotional, psychological, or spiritual symptoms that may affect your retreat experience? *

Yes

If yes, please describe your experience.

Do you currently have a spiritual director? *

Yes

If yes, please provide their name and a form of contact information as a reference.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.