Redemptorist International Pastoral Centre England

application form

Title:
Surname:
First Name:
Congregation/Order:
Abbreviation of Order:
First name you wish to be known by:
Address:
Telephone number:
Date of Birth:
email address:
Country of work:
Present work:

1st choice date of course
2nd choice date of course
Would you please say why you are applying for the course, and what you hope to gain from it:
Yes, I will send a £500 Sterling deposit and a recent photo of myself to confirm this application. (Please note Hawkstone Hall does not accept credit or debit cards)
Please tick

Only for those wishing to join the
Holy Land Pilgrimage

Yes, I want to go to on the Holy Land Pilgrimage.
Please tick
Full name (as on passport):
Expiry date of passport:
Nationality (as on passport):
Yes, I will send an additional £150 sterling deposit by post.
Please tick
Any special requirements, eg diet: