Retreat Request Form
Please complete this form.
Today's date (mm/dd/yy):
Your email address:
Your street address:
Telehone: (include area code)
Cell phone: (include area code)
Area of ministry:
Inner city ministry
Other. Please explain:
How many years have you been in ministry?
Church or ministry name:
Telehone: (incl. area code)
This information is completely
$20,000 & under
$20,000 to $30,000
$30,000 to $40,000
$40,000 to $50,000
Does your church/ministry provide housing?
Quiet Place Ministries serves those in vocational Christian ministry. Since the term Christian is often confused and twisted, we ask that you give us your salvation testimony. Please be specific in this area, as our program is geared to those who know Jesus Christ as their personal Savior. Please use as much space as you need. If both the husband and wife are taking part, please give the testimonies of each. Thank you so much.
Please list specifically why you are requesting a retreat. Please also let us know who the request is for, when you may be able to go, and how far (in hours) you are able to travel.
If the finances are available, and we believe that God has led us to sponsor a retreat for you,
we will contact you with more information. God bless you.
Directors: Brian & Theresa Hendrick
334 Bradley Drive, Jackson, Michigan 49201
Statement of Faith
Testimonials & Prayer Requests
Quiet Place Ministries in Jackson, MI