Reservation Form

Submit a separate Reservation Form for each person and each program.

Send $50 deposit (no more than $100, please) and a SELF-ADDRESSED, STAMPED ENVELOPE for your confirmation. If several confirmations are to be mailed together, put all the names on the envelope.

Reservations will be held for ONLY 10 days pending receipt of deposit.

After April 1, before submitting a reservation please call (609)884-8878 and inquire about available space.

Reservation Form

Last Name
First Name
Name of the program you wish to register for:
Arrival Date
Departure Date
If you are a vowed religious, your congregational initials
Are you a member of the Philadelphia SSJ Associates in Mission? Yes
Street Address
Home Phone
Work Phone
Emergency Contact Name (1)
Contact 1 Phone
Emergency Contact Name (2)
Contact 2 Phone
Health considerations that affect your room assignment
Room Preference
*Do you need a room on the first floor? Yes
*Can you have a room above the second floor? Please do not respond yes unless you are truly able to climb the extra flight of stairs without physical difficulty. Please note that we have almost 50 third floor rooms and cannot accept all reservations without using them. Yes
For a directed retreat, what is your preference for a director? Name of preferred director(s), in order of preference:
If you have no preference for a director for your directed retreat, do you prefer a man or a woman? Man
If we cannot honor these preferences, may we assign you someone else? Yes
*Reservations will be held for ONLY ten (10) days pending receipt of deposit.
* fields are required