4th Day Workshop
The Workshop fee is $10, which includes materials and lunch. (Payable when you sign in)
Date
*
-
Month
-
Day
Year
Date
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
example@example.com
Church
The Weekend You Made Was:
*
DeColores
Emmaus
Via De Christo
Other
Weekend #
*
Best Guess
Weekend Year
*
Best Guess
City Where Weekend Was Held
*
Best Guess
Have you attended a 4th Day Workshop before:
*
Yes
No
If Yes, Date and Location
Best Guess
What Positions Have You Worked? (Check all that apply)
*
Rector/Rectoress
Co-Rector/Rectoress
Coordinator
Cha
Rollista
Musician
Cook
Spiritual Director
Have not worked a weekend
Outside Team Positions Worked:
What Inside and Outside Team positions would you like to work?
Which 3 Rollos (talks) would you be most interested in working on in a group setting? Rank your top 3 (1, 2 and 3)
*
Rank
Ideal
Layman/woman
Piety
Study
Action
Leaders
Environment
CCIA
If you were asked to give a Rollo on a weekend, which one(s) would you prefer?
Are you in a Reunion Group?
*
Yes
No
If not, would you like to be in a Reunion Group?
Yes
No
Do you attend Ultreyas?
*
Always
Sometimes
Seldom
Never
Submit
Should be Empty: