Worldwide Marriage Encounter

Worldwide Marriage Encounter - Northern Indiana Application

To apply for a weekend in Fort Wayne or South Bend, please electronically submit this form. At the end of the process you will be sent to our secure payment processor for payment of the non-refundable application fee.
Personal Information
Last Name Religious
Denomination		 Church
Name (Husband)
Name (Wife)
Street
City
State
Zip Code
Phone    Husband Cell    Wife Cell
Wedding Date
E-mail address    Verify E-mail address
E-mail address 2    Verify E-mail address
Weekend Preferences
1st Choice
2nd Choice
Any Medical,
Physical,
or
Dietary
Restrictions