South Carolina Marriage Encounter Weekend Registration Form
Please print out this form and mail it to our registration couple, Steve and Nydia Burdick, at their address given below. You may also send
an e-mail to scwwme@gmail.com
submitting the registration information as outlined in the form below.
A $50.00, nonrefundable registration fee is required. This fee should be mailed to
Nick and Dianne Monje at their address given below to complete your registration.
Please make your check out to "Worldwide Marriage Encounter".
| Mail Registration CHECK to: Nick & Dianne Monje 18561 Sandpiper Place Leesburg, VA 20176-3914 (703) 771-9765 email: monje@erols.com |
Mail Registration FORM to: Steve & Nydia Burdick 9 Nob Hill, Columbia, SC 29210 (803) 798-8296 email: scwwme@gmail.com |
Please check the Weekend you
would like to attend:
| O | February 5-7, 2010 | Columbia, SC |
| O | October 8-10, 2010 | TBD |
Your information:
| First name (his) | Last name | ||
| Faith (his) | Church/parish | ||
| First name (hers) | Last name | ||
| Faith (hers) | Church/parish | ||
| Phone number | Alt. phone number | ||
| Address | |||
| City, state zip | |||
| Wedding date | E-mail address | ||
| Special needs (diet, mobility, etc.) |
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| Referred by | |||
| How did you hear about Marriage Encounter? |
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| If you have made a Weekend before, please give the date |
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