Print this form out and send:

Name:________________________________________
phone:_____________________________
Address:______________________________________
City: _________________________________________
State:________________________________________
Zip:__________________
Reservation is for a room______ or cottage______   

( check one)
Indicate from the list above choice of (Executive - 3 bdr Del.,

3 bdr Vil, 2bdr Del., 2bdr. Vil., or 1bdr, rooms)
1st choice  ________________
2nd choice ________________

I am willing to help ________. Where would you like to help?
(Children, youth, share-group, etc.)________________________
Suggestions: Please write suggestions concerning any part of the retreat
___________________________________________________
**** Application for Scholarship -
We must have your name and address
I will need a full scholarship_______; partial scholarship_______

(check one)
A brief reason for need of scholarship____________________
_________________________________________________
Please send your application for this retreat to:________________________________________________
Words For Living MinistriesTom C. McKenney - PO Box 413 - Marion, KY 42064  (270) 965-5060
Email: mailto:wflm@apex.net