Before completing this form, please call the office at 248.644.4933 Ext. 0 to confirm your preferred dates are available.• An IDR at Manresa must be a minimum of four full days (96 consecutive hours). • The minimum does not apply to ordained/confirmed religious. • For an ordination or diaconate retreat, please check with your director for specific requirements & criteria.*RequiredName* Mr.Mrs.Ms.Fr.Sr.Br.Dcn. Title First Middle Last Suffix Address* Street Address Address Line 2 City State / Province ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Birthdate and/or Age*(for room assignment)Phone*Email* Emergency Contact’s (EC) Full Name* First Last EC’s Phone Number*EC’s Relationship to the Retreatant*Your Occupation/MinistryYour Religious AffiliationFirst Choice of Dates* (Choose from Sept-April):First choice of dates from:*From YYYY slash MM slash DD First choice of dates to:*To YYYY slash MM slash DD Second Choice of Dates (Choose from Sept-April):Second choice of dates from:From YYYY slash MM slash DD Second choice of dates to:To YYYY slash MM slash DD Time of Arrival* Hours: Minutes AMPM AM/PMTime of Departure* Hours: Minutes AMPM AM/PMPreference for Director* Laywoman Religious Sister Priest No preference(We will do our best to accommodate your preference; however, there is no guarantee.)Accommodations First-floor room (We have an elevator for second-floor rooms.) Diabetic Vegetarian(Please identify any special requirements.)Food allergies and/or dietary restrictions++Our kitchen staff does its best to accommodate a large group of people. If your dietary restrictions are life-threatening or you require specific foods or preparation, we recommend you bring supplemental items for yourself. There is a small refrigerator and a microwave in the dining room for your convenience.Do you have or have you had a Spiritual Director? If currently receiving spiritual direction, how long have you been receiving spiritual direction? If past, how long has it been since you have received spiritual direction?*Is this your first retreat? If no, where have you made a retreat, and when?*Have you made an Individually Directed Retreat before? If so, when and where?*Are you confident and comfortable with a silent retreat?*What are you hoping for in this retreat? (e.g., quiet time with God, direction in prayer, making important decisions, strengthening your faith, et al.)*Additional Comments(regarding your retreat, director preference, et al.)INFORMATION ABOUT THE REQUIRED DEPOSIT AND FEE:Out of Session IDRs (September-April) Price: The application fee/deposit for Individually Directed Retreats is the cost of one night’s stay ($95)This deposit is non-refundable and non-transferable but applied to the cost of the retreat.Out-of-Session Individually Directed Retreats are a set fee ($95 per day) and are not donation based. Your retreat balance will be due before you arrive or when you arrive the day your retreat begins.
