St. Louis ACTS Missions Leadership Workshop Registration Form

Workshop Date: Saturday, February 2, 2013

Time: 8:30 am – 4:00 pm

Place: St. Peter Catholic Church

213 West Argonne, Kirkwood, MO

Ursuline Hall

Registration deadline for this workshop: January 21, 2013

Name: _______________________________________

Address: _____________________________________

City: _______________________________ State: __________ Zip Code: ___________

E-mail Address: ________________________________________

Home Phone: ___________________________ Cell Phone: _______________________

Parish Name: __________________________________________

Month/Year you were a retreatant on your ACTS retreat: _____________________

Reason for Attending/Role:

______Director ______Co-Director ______Spiritual Director/Companion

______Team Member _______Core Member _______Just want to learn more

Registration fee of $10 per person includes lunch.

Please make checks payable to St. Louis ACTS Missions

Mail this registration form with payment to:

St. Louis ACTS Missions

Attn: Bill Grant

602 Lalor Dr.

Manchester, Mo 63011

If you have any questions regarding this workshop, please contact Bill/Anne Grant at or 636.227.3185; Sean/Katy Sperkowski at or 314.353.5825

Note: When we receive your registration form and payment we will send you a confirmation via e-mail.