Preliminary Application for In-Person Retreats
Upon receipt, this application holds your place on our waitlist. At the time retreat dates are
confirmed, you will be asked to complete a more comprehensive application. You are welcome
to contact us at any time to verify that your application is on file or to check your waitlist status.

Please contact us if you have any questions concerning the program or the application process.

Also let us know if your contact information changes (i.e. email address, phone numbers.)

Lastly, please check your spam folder to ensure you haven't missed any emails.

Warmly,
The Abbey Retreat Centre Team
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First Name: *
Last Name: *
Gender/Pronouns: *
Street address: *
Town/City: *
Province/State: *
Postal Code: *
Country: *
Phone Number: *
Email address: *
Birthday: *
MM
/
DD
/
YYYY
Do you work? *
Brief Occupational History: *
Will a partner or friend accompany you in this program as a support person? *
If yes, please provide first and last name of support person:
If yes, please provide the email for support person:
If yes, please provide date of birth of support person:
MM
/
DD
/
YYYY
If yes, please provide the occupation of the support person:
How do you hope to benefit from the Abbey Retreat Centre Cancer Support Retreat? *
How did you hear about this program? *
What is your cancer diagnosis? Please be specific: *
Date of initial diagnosis: *
Do you have any metastases? Please be specific: *
Dates of recurrences, if any: *
Are there any physical limitations you have that would make it difficult for you to fully participate in the cancer support retreat? (Remember: participants need to be able to take care of themselves and participate in a fully-scheduled, 3.5 day-long program) *
Would you like to be notified of cancellations that might enable you to come on short notice? *
If yes, what is the best way to contact you?
Thank you for completing this preliminary application and for your interest in our program. We will confirm receiving your preliminary application by email. If you do not receive confirmation from us within 5 days, please reach out.  
Abbey Retreat Centre is able to offer Cancer Support Retreats to participants at no cost thanks to the generous donations of our partners, our community, our alumni, and fundraising.
Warmly, Barb Smith-Morrison
Executive Director
barb@abbeyretreatcentre.ca
705-754-2966 or 705-854-1615
www.abbeyretreatcentre.ca 
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