Profundo Weekend Registration Form for Clergy

Online application form for Clergy. If you are a married couple, please click here.

Please do not submit an application form more than once. If you need to change your Weekend choices, please call 909-332-7309 and we will be happy to assist you in selecting another Weekend.

Section/Area:

Weekend:

First Names Priest's first name: Last name: Preferred Name (for name tags) Priest:

Contact Information Street address: Street address (cont.): City: State/Province: Postal code: (USA or Canada) Primary email: Alternate email: Primary phone: (XXX-XXX-XXXX) Alternate phone: (XXX-XXX-XXXX)

Original Weekend & Kickoff Dates Original Weekend date: (MM/DD/YYYY) 1st Kickoff Date: (MM/DD/YYYY) 2nd Kickoff Date: (MM/DD/YYYY)

Additional Information Ordination date: (MM/DD/YYYY) Special needs and/or requests: Travel by:

Conditions

I have read the Online Registration Agreement and accept the terms:

The Profundo Weekend

Profundo Weekend Registration Form for Clergy