Invitation Request 1 General Information2 Church Information3 Retreat Information4 Final Questions General InformationStatement of Faith*Please indicate if you accept our Statement of FaithI acceptI do not acceptName* First Last NicknameSpouse's Name*If no spouse write "None" in both fields First Last Spouse's NicknameAddress* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Phone*Cell PhoneEmail* Church InformationChurch Name*Number of People who Worship with you on a Weekend*Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*WebsitePlease use "http://" in the form http://mychurchwebsite.org. Denomination or Association*Type*Senior PastorAssociate PastorI am a*Full-time PastorBi-vocational PastorKey Lay Leader Retreat InformationPlease remember that these retreats are not vacations – they are spiritual retreats for pastors and their spouses (we cannot accommodate children). There is a self-directed program but there is no agenda. Guests may choose whatever they wish of the program and avail themselves of the library or any other means to refocus and reconnect with God and their spouse. We have audio and video resources available but there is no other media. If you wish to bring a laptop for study that is acceptable, but we strongly urge you to use this gift of time to depart from the world of doing and enter a respite of being.The Shack Country Inn (1st choice)*First available03/01/2020-03/06/2020 - Pastor Retreat04/26/2020-05/01/2020 - Pastor Retreat06/14/2020-06/19/2020 - Pastor Retreat07/12/2020-07/17/2020 - Pastor Retreat08/02/2020 - 08/07/2020 - Pastor Retreat10/04/2020 - 10/09/2020 - Pastor Retreat11/01/2020 - 11/06/2020 - Pastor RetreatThe Shack Country Inn (2nd choice)*First available03/01/2020 - 03/06/2020 - Pastor Retreat04/26/2020 - 05/01/2020 - Pastor Retreat06/14/2020 - 06/19/2020 - Pastor Retreat07/12/2020 - 07/17/2020 - Pastor Retreat08/02/2020 - 08/07/2020 - Pastor Retreat10/04/2020 - 10/09/2020 - Pastor Retreat11/01/2020 - 11/06/2020 - Pastor RetreatWhen was the last time you were on a spiritual retreat?*NeverWhere did you go?*Please provide a brief description.Remember that the weeks run from Sunday (check in between 4-8 PM) and check out is Friday at 10 AM. We recommend that guest participate in the full 5-day retreat. Wisconsin is Central Time and Michigan is Eastern Time A Few Final QuestionsHow did you hear about Broom Tree Retreats?*InternetReferralIf other, please tell us how!*In a short paragraph, please tell us how you plan to use your time and what you hope to accomplish while on retreat.*Phone Interview. We would like to speak with you on the phone. Please indicate when would be a good time to do that.Best Days* Mon Tue Wed Thu Fri Sat Sun Best time to reach you*MorningAfternoonEveningIf you have additional comments, please provide them here.Please include a phone number.*For your convenience, we've drafted a letter that you may want to print and give to your Church Governing Board. This iframe contains the logic required to handle Ajax powered Gravity Forms.