Central Minnesota TEC Application Form
Dates of Central Minnesota TEC Weekends: (Please choose one)
_________ CM544 Jun 22 to Jun 24, 2013 _________ CM545 Jul 13 to Jul 15, 2013
_________ CM546 Aug 03 to Aug 05, 2013 _SPECIAL_ CM547 Aug 24 to Aug 26, 2013
_________ CM548 Oct 18 to Oct 20, 2013 _________ CM549 Nov 29 to Dec 01, 2013
_________ CM550 Dec 27 to Dec 29, 2013 _________ CM551 Jan 18 to Jan 20, 2014
_________ CM552 Feb 15 to Feb 17, 2014 _________ CM553 Mar 08 to Mar 10, 2014
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 $95. Please attach a non-refundable $30 registration deposit and
mail this form to Central Minnesota TEC, PO Box 8, Andover, MN 55304.
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: _____________________