Worldwide Marriage Encounter - Allentown Diocese, PA

Preliminary Application Form

Would you like more information - Click here for answers to some common questions

If you are interested in attending a Marriage Encounter, please complete the application below

You can either TAB between fields or move with your mouse.

 

 


Husband's Full Name (First, Middle Initial, Last)

Husband's nickname

Wife's Full Name (First, Middle Initial, Last)

Wife's Nickname

Address 1

Address 2

City

State

Zip Code

E-mail address

Phone Number

Wedding Date:

Husband's Religious Affiliation and Church

Wife's Religious Affiliation and Church

Select an experience or weekend

Select an alternate experience or weekend

Do you have any special needs (diet, handicap, etc) so that we may accommodate you accordingly?


How did you hear about Worldwide Marriage Encounter?


 

This is only a preliminary application.  To guarantee your application please mail $75.00 non-refundable application fee to the registration couple (address below).  At the end of the weekend you will be given an opportunity to give a free will offering which will cover the expenses for the weekend.  These expenses vary depending on the location of the weekend.  Currently these expense are approximately $400.00. Our registration couple can discuss this with you if you have any questions. 

  Please check here to state that you are mailing your deposit.

PRIVACY INFORMATION:

Please note for security purposes, when you submit this form, you will first be directed to a Bravenet webpage asking you to verify that you intended to submit information via the web. Worldwide Marriage Encounter uses the information you submit for registration and to contact you for making your weekend together. Your personal information will not be distributed outside of Marriage Encounter or sold. Please note that the security of transmission of this information is the same as any e-mail, and could potentially be intercepted. Please do not provide any credit card numbers in this submittal.


A $75.00 non-refundable application fee is required to confirm your registration. 
Send your deposit (a check payable to "Worldwide Marriage Encounter") to :

Worldwide Marriage Encounter

1968 Robin Ct

Bethlehem, PA 18015

 

If you have any further questions or you would like to speak to someone personally please call

1-800-787-7679

To E-mail the registration couple please click here

Click here if you wish to have a printer friendly page to fill out and mail to our registration couple.

Information from this page is e-mailed directly to our registration couple. They will call you to confirm your application.  Thank you.


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Modified on 02/19/2012