Last Name: 
Husband's First Name: 
   Wife's First Name: 
            Address1: 
            Address2: 
                City: 
               State: 
            ZIP Code: 
          Home Phone: 
               Email: 
 Prefer Smoking Room: Yes  |  No
        Wedding Date: 
     Weekend Desired: 
		
		November 9-11, 2007 at Priestfield, WV Retreat Ctr.
		February 8-10, 2008 at Priestfield, WV Retreat Ctr.
		
		August 8-10, 2008 at Priestfield, WV Retreat Ctr.
		
		November 7-9, 2008 at Priestfield, WV Retreat Ctr.
		
		
  Husband's Religion: 
    Husband's Church: 
     Wife's Religion: 
       Wife's Church: 

How or from whom did you learn about Marriage Encounter?

Other comments or special needs:

A non-refundable registration fee of $50 is required to confirm your reservation, food and lodging; we'll process your registration when we receive your registration payment.

Weekends have a limited capacity and often fill up, so early registration is encouraged. Please make your check payable to Worldwide Marriage Encounter. Mail your registration check to:

Worldwide Marriage Encounter
c/o Larry & Carolyn Conway
3304 Woodside Ave
Baltimore, MD 21234