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             Preliminary Registration Form

 

                            If you are interested in attending a Marriage Encounter, please fill out this form.  

                       Please use TABs or mouse clicks to move from field to field.

                                                     Husband's first and last name:

                                                           Wife's first and last name:

                                                                           Street Address:

                                                                                           City: State: Zip Code:

                                                             Daytime Phone Number: Evening Phone Number:

                                                                   Your Email Address: Your Wedding Date:

                                  Which weekend would you like to attend?

                                                    Please select an alternate date:

                                                                   Number of children:

                                      Husband's Religion and Parish/Church:

                                            Wife's Religion and Parish/Church:

                                      How did you hear about the weekend? 

                                              

                                    

                                    A $50 non-refundable deposit is required to confirm your registration.
                                    Send your deposit (a check payable to "Marriage Encounter New England") to:       Marriage Encounter New England
                                                                                                                                                                        65 Waters Edge Rd.
                                                                                                                                                                        Tiverton RI, 02878

                                    If you prefer, you can print out this page, fill it out and mail it with your deposit to the same address.              

                                    Return to the Marriage Encounter Homepage. If you have question or want to give us feedback, click here.        

                                    Last updated November 4, 2005