Home Address:

Phone Number:   Email:

Name of School:   Name of Parish:

Date of Birth:

Gender (M or F):

Parent Name(s):

Please answer the following 3 questions:

1. What issues are you passionate about? What are you prepared to do about them?

2. What does "doing a little good" mean to you?

3. What do you expect to get out of the retreat? List any topics or issues you would like to learn more about.

• Registration deadline is March 17th, 2008
• Registration fee is $75.00, to be paid on acceptance (administration will be contacting you for payment)
• Successful applicants under the age of 18 will require signed permission from their legal guardian(s)
• Agenda, medical, transportation and photo release as well as any other forms and information, will be included in the retreat package sent to you upon request