2025 Rural Ministry Immersion Program Registration

Basic Information about Registrant:

Legal Last Name:

Legal First Name:

Legal Middle Name:

Religious Name (if applicable):

Mailing Address:

Number and Street

Mailing Address Line 2:

City:

State/Province:

ZIP or Postal Code:

Country:

Email Address:

Telephone Number:

Preferred Method of Contact:

	Email
	Telephone
	Text Messaging
	Other

Emergency Contact Name and Telephone Number:

I am a:

	Ministry professional seeking enrichment/development
	Seminarian
	New or currently enrolled SOT/Sem student
	Currently enrolled MACC/UIW student
	Other:

SOT/Sem Students Only: I am registering for:

	PTHM 459 Field Education
	MORL 456 Rural Social Issues
	Enrichment Experience Only, no class credit

SOT/Sem Students Only: Acknowledgement of Class Registration

I acknowledge that if seeking credit for PTHM 459 Field Education or MORL 456 Rural Social Issues, I have registered for that respective course through the regular university summer registration process. If applicable, I am arranging summer housing through the university summer registration process.

Immersion Program Details:

Payment Method:

	Electronic Payment Online payment page follows submission of form. Select if you are SOT/Sem student seeking experience only, no credit
	Pay by check Please mail to Sustained Encuentro Program, Saint John's School of Theology, P.O BOX 7288, Collegeville, MN, 56321
	Payment through MACC/University of Incarnate Word/Archdiocese of San Antonio
	SOT/Sem student, seeking graduate credit. Payment is through regular tuition process.

Full Immersion Program includes three meals per day, starting with Dinner on May 30 and ending with Dinner on June 6. Also includes daily transportation to sites.

Attendance Options:

	Full Immersion Program with Housing, Single Room, Shared Bathroom	$720.00
	Full Immersion Program with Housing, Single Room, Private Bathroom	$760.00
	Full Immersion Program, with no Housing	$600.00
	Full Immersion Program, and I am an SOT/Sem student, seeking credit with summer school housing separately arranged	$0.00
	Full Immersion Program, and I am an SOT/Sem student seeking the program experience only, no credit.	$300.00

Refund Policy: Please acknowledge by checking box

Refund Policy for Program Fee Only: Please note that refunding of program and housing fees is possible through May 16, 2025. We will retain a $30 processing fee for all refunds. No refunds are issued after May 16. *For those seeking graduate credit, the tuition refund policy is consistent with the overall refund policy for summer courses: "For the summer term, students withdrawing before the second Wednesday of May will be granted 100% credit. If they withdraw between the second Wednesday of May and June 1st, they will receive 25% credit back. If they withdraw after June 1st, there will be no refund."

Acknowledgement of Program Dates:

I acknowledge that the Rural Immersion Program requests my attendance from the evening of Friday May 30 through the evening of Friday,June 6. I commit to making travel arrangements around this.

Arrival and Departure Information:

Please indicate your arrival and departure date if housing on campus

	Flight Information:		Airline Name and Flight Number
	Arrival date and time:
	Departure date and time:

Special Dietary Needs:

Special Physical Needs:

Comments or Additional Needs:

Hospitality is an important value to us and is integral to our Benedictine mission. Please indicate if there is anything we can be attentive to as we welcome you to the program.

Communications:

Please share how you learned about this program:

Would you be interested in hearing more about opportunities at Saint John's School of Theology and Seminary from a member of our admission team?

	Yes
	No