Central Minnesota TEC Application Form
Dates of Central Minnesota TEC Weekends: (Please choose one)
_________ CM508 Sep 25 to Sep 27, 2010 _________ CM509 Oct 22 to Oct 24, 2010
_________ CM510 Nov 05 to Nov 07, 2010 _________ CM511 Nov 26 to Nov 28, 2010
The retreat begins at 9:30 AM the first day and concludes at 5:00 PM the third day.
Name ________________________________________ Sex___ Birthday________*Age_____
Preferred Name on Name Tag________________________ Email:_____________________
Permanent Address ____________________________________________________________
City__________________________ State_________ Zip________ Phone_______________
Address Used During School Year ______________________________________________
City__________________________ State_________ Zip________ Phone_______________
Marital Status ________________________ Spouse's Name ________________________
Religion___________________ School__________________________ Grad Year________
Parish___________________________________ Pastor______________________________
Parish Address______________________________ City__________ State___ Zip _____
Parent's Name_________________________________________________________________
Do you have any health or physical needs? ____________________________________
How did you find out about TEC?(Please use specific names) _________________________________________________
*Age: Must be at least 16 years old or a junior in High School.
Total cost of weekend is $75. Please attach a non-refundable $30 registration deposit and
mail this form to Central Minnesota TEC, PO Box 500, 104 Crosier Dr. N, Onamia, MN 56359.
Phone 320-532-4455, Fax 320-532-4459. Weekends are held in Little Falls, MN.
Phone during a weekend 320-632-1675. Once your application is submitted
you can assume you
have been accepted. Exceptions will be notified by mail immediately.
A letter with full
details regarding the retreat will be sent to you two weeks prior to your
weekend.
If you are a student living at home, please ask your parent or guardian to sign this
application and medical waiver. In case of illness or injury, I authorize those in
charge of the TEC weekend that my son or daughter attends, to obtain whatever medial
assistance that seems necessary for his or her well being.
Signed by ___________________________________ Phone: _____________________