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Plan a Visit to Richmond

Register on-line by completing the form below for attending the Days for Discernment in Richmond, Virginia.

Please Note: (Fields with an asterisk "*" only are required.)

After completing this form, click the "Submit" button below.
Your registration form will be sent to the Office of Admissions.
A confirming copy will be sent to you by email. Please print a copy of your confirmation to mail with your fees.
For each person, send a $30 reservation fee (includes a $20 non-refundable fee, along with a $10 key deposit for those staying on campus, and will be refunded with return of key at the end of the weekend). Make checks payable to Union-PSCE.
Mail a copy of your confirmation form and check to:

Days for Discernment
c/o Amanda Montague
3401 Brook Road
Richmond, VA 23227

NOTE: If you are registering within two weeks of the next D4D, please contact Amanda Montague at (800)229-2990, ext. 221 to arrange payment of your registration fee.

Name*:

Nick Name:

Mailing Address:

Address (1):

Address (2):

City: State, Zip:

Gender:

Male Female

Age:

E-Mail Address*:

Home Phone:

Work Phone:

Cell:

College:

Graduation Date:

Degree:

Denomination:

Occupation (if out of school):

Pastor's Name:

Name of Congregation of Membership:

I am interested in: (check all that apply)

Master of Arts in Christian Education
Master of Divinity
Dual (M.Div./M.A.C.E.)
Limited Enrollment (non-degree)

Date for upcoming Days for Discernment in Richmond.

October 4-6, 2009 (College Edition)
November 1-3, 2009
January 31-February 2, 2010 (College Edition)

Housing and Transportation

Arrange housing for me and my spouse on campus
Arrange meals for me and my spouse on campus

I/we will need a room that is handicapped accessible
I/we will bring children.

Boys' ages

Girls' ages

Spouse's name:

I/we will arrive in Richmond on:

at (time):

by:

I/we will depart Richmond on

at (time):

by:

I/we will need to be met:

Carrier Name:

Arrival Time:

Departure Time:

All rooms are double occupancy.
Name of preferred roommate:

Comments or Questions:

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