March 17, 2017 ALVDC Communications Weekend Application Weekend Application Last name * First name * Email Address * Phone # * Birthdate * Gender * Male Female Street Address * City * State * Zip * Name of Church * Pastor Have you been baptized? * yes no Sponsor Name * Sponsor Email Marital Status * Married Single Divorced Widowed Wife or Husband's Name Wife or Husband's Email Spouse's Phone# Medical & Dietary Requirements PLEASE NOTE ANY DIETARY OR MEDICAL NECESSITIES YOU HAVE WHICH REQUIRE SPECIAL ATTENTION: Weekend Fee * Please talk to your sponsor regarding the cost of the weekend ($110). We have a limited number of scholarships available. Let us know if you require a scholarship here. I do not require a scholarship I would like to receive a scholarship. Request to attend I would like to attend the upcoming Atlanta Lutheran Via de Cristo weekend. If you are human, leave this field blank.
