Note: It is the policy of St. John Neumann Church to protect the information that you give us. The information collected below will be used by St. John Neumann parish staff and volunteers to update and maintain our parish records and will only be provided to those who are members of the retreat team.

Name:
Street Address:
City/State:
ZIP Code:
E-mail Address:
Home Phone:
Work Phone:
Are you a registered parishioner at St. John Neumann?   Yes       No
You are signing up for the Men's Weekend (November 8-9, 2008)
Comments or special accommodations needed for the weekend: