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Husband's first and last name:
Wife's first and last name:
Street Address:
City:
State:
Zip Code:
Work Phone Number (area code):
Home Phone Number (area code):
Your Email Address:
Your Wedding Date:
Which weekend would you like to attend?
Please select an alternate date:
Number of children:
Husband's Religion and Parish/Church:
Wife's Religion and Parish/Church:

How did you hear about the weekend?

A $50 non-refundable deposit is required to confirm your application.
Send your deposit (a check payable to "Worldwide Marriage Encounter") to:

Paul & Kim Gilbert   1 Pauline Place,   Griswold, CT 06351
You can call us at  860-376-0440    or  800-795-LOVE (5683)
Or E-Mail us at Registration@wwmeCT.org

If you prefer, you can print out this page, fill it out and mail it with your deposit to the Gilberts at the address shown above.



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