St. Mary Convent - Coptic Orthodox Diocese of the Southern U.S.

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Individual Registration

Individuals, who wish to spend a retreat at St. Mary Convent, must follow the Retreat Center Rules and Guidelines and fill out the form below. Only females are allowed to stay at the convent.

A permission letter is required from every individual that would like to take the blessing of staying overnight at the Convent. Only females can stay at the Convent. Please note that the registration will not be complete except if you have a permission letter form your Confessor Father, submitted to (817) 704-2389, in the same day you register online.

First Name

Last Name

Street Address

City

State or Province Click to choose... Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory

Zip Code

Country
If you live outside of the US or Canada

Main Phone
(###) ###-####

Email Address

Marital Status Click to choose... Single Married Widowed

Age Range Click to choose... Under 18 18-25 26-44 45-65 Over 65

Denomination

Church Name

Church City

Church State or Province Click to choose... Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory

Confessor Father

Way of travel? Click to choose... Car Plane Bus

Arrival Date
YYYY-MM-DD

Departure Date
YYYY-MM-DD

Comments / Notes