Tres Dias of North Georgia Application

Tres Dias of North Georgia Application

Married Couples
If you are a married couple, please complete page one with the husband's information and page two with the wife's information. Page three is to be completed with sponsor information.
Applicant's (Husband) Name *

First Name Last Name
Applicant's (Husband) Email *
example@example.com
Applicant's (Husband) Phone Number *

- Area Code Phone Number

Applicant's Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Age (Husband) *
Your Home Church
Are you a pastor (Husband) *

Yes No
Please list any Dietary Restrictions or Food Allergies (Husband) *
Please provide us a physical overview so we can better accomodate you. (Husband) *
Emergency Contact Name *
Emergency Contact Number *
Emergency Contact Relationship *

In the space below, please indicate your first and second choice for the set of weekends you would like to attend from the list below: (Example: "Our first choice is the May set of weekends. Our second choice is the July set of weekends")

If you are available to be called at the last minute for an earlier weekend, please make a note to this effect in the notes section at the end of this application.

May Weekends: Men's #137, May 16 - 19 / Women's #151, May 23 - 26
July Weekends: Men's #138, July 11 - 14 / Women's #152, July 18 - 21
October Weekends: Men's #138, October 3 - 6 / Women's #153, October 10 - 13

Enter your weekend selections (1st & 2nd choices) below: *

Applicant's (Wife) Name *

First Name Last Name
Applicant's (Wife) Email *
example@example.com
Applicant's (Wife) Phone Number *

- Area Code Phone Number
Age (Wife) *
Your Home Church
Pastor (Wife) *

Yes No
Please list any Dietary Restrictions or Food Allergies (Wife) *
Please provide us a physical overview so we can better accomodate you. (Wife) *
Emergency Contact Name *
Emergency Contact Number *
Emergency Contact Relationship *

Sponsor Name *

First Name Last Name
Sponsor Email *
example@example.com
Sponsor Cell Phone Number *

- Area Code Phone Number
Community & Weekend Sponsor Attended *
Notes (if needed) to Pre-Weekend Team from Candidate or Sponsor:
Should be Empty: