The Jesuit Spirituality Center

at St. Charles College

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Enter the name of the retreat desired (if Directed retreat, please indicate 3, 5 or 8 days)*

Please confirm with your initials that you will have been fully vaccinated (including booster) two full weeks before the start of your retreat. Please bring your vaccination card with you when you come.*

Retreat Start Date*

Title (Mr. Mrs. Miss. Sr. Fr.)

Name*

First Last

Address*

Mailing Address Address Line 2 City State ZIP / Postal Code

Day Time Phone*

Birth Date

Occupation

Religious Denomination

Have you made a directed retreat before at the Spirituality Center?

Yes

Have you made one elsewhere?

Yes

A name and phone # to contact in case of an emergency:*

Special Needs?

A non-refundable deposit of $75 is required for all retreats.

Three-Day Retreat Fee: $285
Five-Day Retreat Fee: $475
Eight-Day Retreat Fee: $710
30-Day Retreat Fee: $2,800

Fees for Weekend Programs / Special Retreats
Please refer to the specific program you wish to attend for the applicable fee. If you are attending a morning or day program, the full fee is due with registration. If you are attending a multi-day program, a deposit of $75 is required with registration.

With all retreats, you are welcome to pay more than the minimum $75 deposit fee with your registration if you desire.

Retreat fee you are paying today: (Please Enter $ Amount)*

Additional Donation if desired: (Please Enter $ Amount)

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Jesuit Spirituality Center, Grand Coteau, Louisiana 70541 Phone: 337.662.5251Fax: 337.662.3187

Jesuit Spirituality Center, Grand Coteau, Louisiana 70541

Phone: 337.662.5251

Fax: 337.662.3187