Initial Inquiry Form for Group Hosting

Initial Inquiry Form For Group Hosting
Please fill out this form with information about your group and the dates you are interested in coming to Mercy Conference and Retreat Center. As soon as we get your information, we will review your request, check our availability, and respond to your request within 1 business day.
Your Name*

First NameLast Name
Email address*
example@example.com
Phone Number*
Please enter a valid phone number.
Name of Your Group*
Planning Information
What Type of Meeting or Retreat*

Day or Partial DayMultiple DaysOvernight or Multiple Nights
How many people will be in the group? (Initial estimate)
Commuters*
Overnight*
If Overnight Accommodations are Needed, Will Singles, Doubles, or a Mix Be Needed?
Anticipated start and end date(s) and times?
Anticipated Start Date and Time
Anticipated Start Date*

MonthDayYear
Date
Anticipated Start Time*

Hour Minutes

AM/PM Option
Anticipated End Date and Time
Anticipated End Date*

MonthDayYear
Date
Anticipated End Time*

Hour Minutes

AM/PM Option
Are alternative dates possible? If so, list alternative dates, or enter the word NO.*
General Information
Have you been to Mercy Center before? If Yes, when was the approximate year of your last visit? If No, how did you find out about us?*
Were you referred by someone?*

YesNo
If yes, please share the name of the individual or group.
Your Anticipated End Date and Time is before your Anticipated Arrival Date and Time. Please correct and you will be allowed to submit the request.
Thank you for providing this information.
Should be Empty:

Initial Inquiry Form For Group Hosting

Planning Information

General Information