Tres Dias of North Georgia Application - Married Couple

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 *
Your Home Church
Are you a pastor *

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

Weekend Selection for Married Couples: Please select a 1st and 2nd choice from the list below. *

	Select 1st / 2nd Choice
2018 - Men's #134 July 12-15 / Women's #148 July 19-22
2018 - Men's #135 Oct 4-7 / Women's #149 Oct 11-14
2019 - Men's #136 Feb 21-24 / Women's #150 Feb 28 - March 3
2019 - Men's #137 May 16-10 / Women's #151 May 23-26

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 *
Your Home Church
Pastor *

Yes No
Please list any Dietary Restrictions or Food Allergies *
Please provide us a physical overview so we can better accomodate you. *
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:

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