Jesuit Retreat House - IDR registration form

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The Jesuit Retreat House
5629 State Road
Parma, OH 44134
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Phone: 440.884.9300
Fax: 440.885.1055
E-Mail: [email protected]

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What Is A Retreat? | Calendar | Typical Retreat Schedule

Individually Directed Retreats

Individually Directed Retreats utilize the Spiritual Exercises of St. Ignatius of Loyola to help move you closer to God through the gift of prayer. These retreats are ideal for anyone seeking to deepen one's relationship with God and take the next step in his or her spiritual life. Through daily one-on-one meetings with an experienced retreat director, the retreatant becomes more aware of God's presence and activity, comes to trust this awareness, and responds to this presence and activity.
Thank you for taking the time to register for one of our Individually Directed Retreats. Please fill out this form. To help us better understand your spiritual needs please complete all fields. All information is confidential and only for the use of spiritual directors.

When your $50 deposit is received, your registration is confirmed. If there is a problem, we will contact you. For any other questions, please contact us at (440) 884-9300 or [email protected].

Requested Retreat Dates

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Last Name
First Name

Address
City

State
Zip

Home Phone

Work Phone

Date of Birth
(Mo/Day/Year)
Male
Married
Religious Female
Single
Ordained

No. of Children
Education Completed
Your Work/ Ministry

Parish/Religious Order
E-Mail Address

What has been your recent retreat experience? Can you describe what kind of retreat it was?

If you have a preference for a director, we will try to accommodate you. We cannot promise that the director will be available.

Director's Name

1. Can you say something about your prayer life?

2. Why do you want to make this Individually Directed Retreat?

Payment Infomation:
For your convenience we now have the option of paying with credit cards (only VISA or MasterCard). This is a secure Web site, which means your credit card information is encrypted. Jesuit Retreat House information is secured through a Thawte certificate (see Thawte logo below).

Name on the credit card

Amount

Visa or MasterCard

Expiration Date

Credit Card Number