RICHMOND EMMAUS PILGRAM APPLICATION

RICHMOND EMMAUS COMMUNITY APPLICATION TO ATTEND A "WALK TO EMMAUS" WEEKEND
Name
Preferred name
Street
City
State/Zip
Home Phone
Format: (000) 000-0000.
Alternate Phone
Format: (000) 000-0000.
E mail
example@example.com
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Gender:
Occupation
Marital Status
Spouse's First Name
Has your spouse attended a Walk to Emmaus or submitted an application?
Do you have a medical device that requires your phone for monitoring purposes?
Do you have any mobility conditions or dietary restrictions we must be aware of?
(If YES, please list all dietary restrictions and/or medication SO that we can accommodate your needs during your Walk. In addition, list all mobility issues you may have. This information will be kept confidential and will not prevent you from attending a Walk.)
Home Church
Denomination
Church Address
Church Phone Number
Format: (000) 000-0000.
Pastor
Sponsor's Name
Please note Church/Community Involvement
Please state briefly why you want to attend an Emmaus weekend, what you expect from the experience, and any other information about yourself or your faith you wish to share
NOTE: This application expresses your desire to participate in a Walk to Emmaus event. You will receive notification of your acceptance for a weekend approximately one month beforehand; however, we cannot guarantee acceptance for a particular Walk. A $50.00 non-refundable application fee payable to "Richmond Emmaus," is required. THERE ARE NO ADDITIONAL COSTS TO YOU FOR THE WEEKEND. After completing this application, notify your sponsor so they can complete their information. In addition, you may give your sponsor a check for the application fee or visit https://richmondemmaus.com/give.

If you have questions, please get in touch with your sponsor.
Signature of Applicant
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

RICHMOND EMMAUS COMMUNITY APPLICATION TO ATTEND A "WALK TO EMMAUS" WEEKEND