R3 Pilot Retreat Application Form
A guided wellness process for pastors and ministry leaders. Includes a 5-day Retreat, 4 Coaching Sessions, R3 Vitals Assessment, and more.
Name
*
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
E-mail
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How long have you been in vocational ministry?
*
Would you like to share this process with your spouse?
*
Yes
No
Spouses Name (if applicable)
First & Last Name
Select your current role.
*
Lead Pastor
Executive Pastor
Associate Pastor
Ministry Director/Leader
Students Pastor/Leader
Kids Pastor/Leader
Creative Pastor/Leader
Select Your Preferred Retreat Schedule (choose 3-7 consecutive days)
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Please provide 2-3 sets of dates as booking options for this calendar year.
*
Must be a minimum of 6 weeks out from current date. Exceptions can be made.
Briefly share what led you to pursue vocational ministry.
*
In 3-5 sentences, please share what areas you hope to concentrate on during this process.
*
How do you hope this experience impacts your life and ministry?
*
Are you willing to participate in all provided services? (5-Day Retreat, 4 Pastoral Coaching Sessions, R3 Vitals Assessment(s), Resourcing)
*
Yes, I want to participate in all services.
No, I would like to customize my experience with an R3 Pastoral Coach.
Submit
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