Matt Talbot Retreat Movement, Inc.

Group Data Sheet

Group Number: ____________
Date: ______________

After each retreat, please send this information to the address below. Also, please send a list of new retreatants. This can be on a plain piece of paper. We don't need individual cards for each retreatant. We need the medallion number, first and last names (last initial only is not acceptable). NOTE: make certain your group number is on your list of new retreatants. Also, it helps if the list is ordered by medallion number.

Chairperson/President
Name: ___________________________________________________
 
Address: ___________________________________________________
 
___________________________________________________
 
City, State, Zip Code: __________________________________________________
 
Phone Number: (_____)_______________________
 
Email Address: ________________________________

Secretary
Name: ___________________________________________________
 
Address: ___________________________________________________
 
___________________________________________________
 
City, State, Zip Code: __________________________________________________
 
Phone Number: (_____)_______________________
 
Email Address: ________________________________

Treasurer
Name: ___________________________________________________
 
Address: ___________________________________________________
 
___________________________________________________
 
City, State, Zip Code: __________________________________________________
 
Phone Number: (_____)_______________________
 
Email Address: ________________________________


Group Retreat Schedule (future retreats)
Start Date
End Date
Retreat House (name and city)
Group Retreat Contact
       
       
       
       
       
       
       
       

Retreat Masters Your Group Would Recommend
Name:
_____________________________________
Address:
_____________________________________
  _____________________________________
City, State, Zip:
_____________________________________
Phone Number:
(____)_______________________________
email Address:
_____________________________________
 
Name:
_____________________________________
Address:
_____________________________________
  _____________________________________
City, State, Zip:
_____________________________________
Phone Number:
(____)_______________________________
email Address:
_____________________________________
 
Name:
_____________________________________
Address:
_____________________________________
  _____________________________________
City, State, Zip:
_____________________________________
Phone Number:
(____)_______________________________
email Address:
_____________________________________
   
Name:
_____________________________________
Address:
_____________________________________
  _____________________________________
City, State, Zip:
_____________________________________
Phone Number:
(____)_______________________________
email Address:
_____________________________________

Please send this information to:
Matt Talbot Retreat Movement, Inc.
32 Watkins Drive
Sandy Hook, CT 06482