Belleville Area Worldwide Marriage Encounter - Online Registration for Clergy

Applications; 888-889-9963

a weekend of discovery

a lifetime of love

Worldwide Marriage Encounter

Belleville, IL

Serving the Diocese of Belleville
and surrounding communities

››› WWME.org

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Online Application Form for Couples

If you are clergy, please apply by clicking here.

Bold fields are required.

Step 1 of 5
*Required Field - Closed Weekends cannot be selected.

Tell us which Weekend is your first choice

Belleville Sep 18-19, 2010 [ Waterloo, IL ]
Nov 12-14, 2010 [ Belleville, IL ]

St. Louis Aug 6-8, 2010 [ St. Louis, MO ]
Sep 24-26, 2010 [ St. Louis, MO ]
Dec 3-5, 2010 [ St. Louis, MO ]
Step 2 of 5
*Required Field - Closed Weekends cannot be selected.

Tell us which Weekend is your second choice

Belleville Sep 18-19, 2010 [ Waterloo, IL ]
Nov 12-14, 2010 [ Belleville, IL ]

St. Louis Aug 6-8, 2010 [ St. Louis, MO ]
Sep 24-26, 2010 [ St. Louis, MO ]
Dec 3-5, 2010 [ St. Louis, MO ]
Step 3 of 5
*Required Field

Tell us a little about yourselves.
Husband's preferred first name:
Wife's preferred first name:
Last name:
Wife's preferred last name:
(if different)
Address line 1:
Address line 2:
City:
State:
Zip:
Primary contact number:
Alternate contact number:
Wedding date:
Primary email address:
Have you previously attended
a WWME Weekend? No: Yes:
Step 4 of 5
*Required Field

Tell us about your preferences
Husband's faith preference:
Husband's church/parish:
Wife's faith preference:
Wife's church/parish:

Discount Code:
Notes/Dietary requirements//Special instructions:

Room preference
(Hotels only):   Non-smoking:      Smoking:

Application fee payment method:   PayPal:      Personal check:
Is this application form for yourself?   No:      Yes:
Step 5 of 5
*Required Field

Tell us how you found WWME and the Weekend
(select all that apply)
Advertisement
Church bulletin
Encountered
Friends
Info night/Dinner
Mass Talks
Other
Priest/Pastor
Relative/Family
Website/Internet

If someone encouraged you to attend a Weekend, please let us know.
Referred by:
Phone number:

Tell us which Weekend is your first choice

Tell us which Weekend is your second choice

Tell us a little about yourselves.

Tell us about your preferences

Tell us how you found WWME and the Weekend (select all that apply)

Tell us how you found WWME and the Weekend
(select all that apply)