Central Minnesota TEC Application Form

Dates of Central Minnesota TEC Weekends: (Please choose one)

______ CM617 (Fri) Oct 18-(Sun) Oct 20, 2019 ______ CM618 (Fri) Nov 29-(Sun) Dec 01, 2019
______ CM619 (Fri) Dec 27-(Sun) Dec 29, 2019 ______ CM620 (Sat) Jan 18-(Mon) Jan 20, 2020
______ CM621 (Sat) Feb 15-(Mon) Feb 17, 2020 ______ CM622 (Sat) Mar 14-(Mon) Mar 16, 2020
______ CM623 (Fri) Apr 03-(Sun) Apr 05, 2020 ______ CM624 (Sat) May 16-(Mon) May 18, 2020
______ CM625 (Sat) Jun 27-(Mon) Jun 29, 2020 ______ CM626 (Wed) Jul 15-(Fri) Jul 17, 2020
______ CM627 (Fri) Aug 07-(Sun) Aug 09, 2020

The retreat begins at 9:30 AM the first day and concludes at 5:00 PM the third day.

Name ________________________________________ Sex___ Birthday________*Age_____

Preferred Name on Name Tag________________________ Email:_____________________

Permanent Address ____________________________________________________________

City__________________________ State_________ Zip________ Phone_______________

Emergency Phone Number while attending TEC:__________________

Address Used During School Year ______________________________________________

City__________________________ State_________ Zip________ Phone_______________

Marital Status ________________________ Spouse's Name ________________________

Religion___________________ School__________________________ Grad Year________

Parish___________________________________ Pastor______________________________

Parish Address______________________________ City__________ State___ Zip _____

Parent's Name_________________________________________________________________

Do you have any special dietary or health needs? _____________________________

How did you find out about TEC?(Please use specific names) _________________________________________________

*Age: Must be at least 16 years old or in spring semester of sophomore year in high school.

Total cost of weekend is $95. Please attach a non-refundable $30 registration deposit and
mail this form to Central Minnesota TEC, PO Box 8, Andover, MN 55304.
Phone 320-532-4455. Weekends are held in Little Falls, MN.
Phone during a weekend 320-632-1675.  Once your application is submitted you can assume you
have been accepted. Exceptions will be notified by mail immediately.  A letter with full
details regarding the retreat will be sent to you two weeks prior to your weekend.

If you are a student living at home, please ask your parent or guardian to sign this
application and medical waiver. In case of illness or injury, I authorize those in
charge of the TEC weekend that my son or daughter attends, to obtain whatever medial
assistance that seems necessary for his or her well being.

Signed by ___________________________________ Phone: _____________________