SAN DIEGO WALK TO EMMAUS
PILGRIM APPLICATION

City:  ______________________State: ____  Zip: ______ -_____ Phone: (_____)__________________

Name wished on name tag: _____________________________________________________________

Name of church now attending: ____________________   Denomination: ______________________

Pastor's name & Address: ______________________________________________________________

Your age: ___ No. of children: ____ Circle one: Married//Single//Divorced//Separated//Widowed

Present Occupation:   __________________________________________________________________

Religious or civic organization you are involved in? _______________________________________

______________________________________________________________________________________

Has the Walk to Emmaus been explained to you? _____
Have the follow-up programs of Fourth Day and Group Reunions been explained to you?    _____

Are you on a special diet?  _____ If yes, what kind? ________________________________________

Do you have a health problem or physical handicap that may affect your attendance at Walk to

Emmaus?  If yes, please specify: ________________________________________________________

State briefly why you wish to be involved in the Walk to Emmaus and what you expect of it.

______________________________________________________________________________________

______________________________________________________________________________________

The Walk to Emmaus is a short course in Christianity to deepen our knowledge of
God's Grace active in our lives. The Emmaus weekend runs from Thursday evening
to Sunday afternoon, and encourages a lifetime of continued community after the
weekend. In the case of married persons, both parties must make a commitment
to attend. Sometimes there is a waiting list, so please be patient. It may be some
months before you will be contacted.

All of the above information is necessary for your proper placement on a Walk to Emmaus.
Please fill in all the blanks.

Signature: _______________________________________________________ Date: _______________

PLEASE RETURN THIS FORM TO YOUR SPONSOR FOR COMPLETION.
PLEASE INCLUDE A NON REFUNDABLE DEPOSIT OF $15.