Sponsor Application

This application is for people that have already been a part of Walk to Emmaus.
(Do NOT give this form to the Pilgrim.)

Contact Information

Your Name (Sponsor):

*

Address:

*

Phone:

*

Email:

*

This address will receive a confirmation email

Pilgrim's Name:

*

Pilgrim's Address:

*

Pilgrim's Phone Number:

*

Pilgrim's Email:

*

Place of Sponsor's Walk to Emmaus:

*

Date of Sponsor's Walk:

*

Sponsor's Church Affiliation:

*

Attend Regularly?

*

Please select one option.

Yes No

Are you in a Reunion Group?

*

Please select one option.

Yes No

Have you sponsored a Pilgrim(s) in the past?

*

Please select one option.

Yes No

Are you praying and sacrificing for this Pilgrim?

*

Please select one option.

Yes No

How long have you known this Pilgrim?

*

Why do you feel this Pilgrim would benefit from a Walk to Emmaus?

*

List any special requirements or preparations needed to accommodate this Pilgrim:

*

Is this Pilgrim under any temporary, emotional strain that might indicate their Walk to Emmaus should be postponed?

*

Please select one option.

Yes No

Are you able and willing to assist the Pilgrim in finding and getting involved with a Reunion Group?

*

Please select one option.

Yes No

If the Pilgrim is married, have you discussed the Walk to Emmaus with the Spouse?

*

Please select one option.

Yes No N/A

As the Sponsor, I will...

*

Please select all that apply.

bring the Pilgrim to sendoff. attend Sponsor's hour. attend the candlelight service. attend closing.

Can you care for the needs of the Pilgrim's family during the Walk?

*

Please select one option.

Yes No

Can you refrain from personal contact with your Pilgrim during the Walk (especially if the Pilgrim is your Spouse)?

*

Please select one option.

Yes No

Is there anything you are aware of that the team should know to make this a better Walk for the Pilgrim?

*

Please select one option.

Yes No

If YES, please explain:

What is the Pilgrim's current occupation?

*

Does the Pilgrim have any special hobbies and/or interests? Please explain.

*

Community Newsletter/Communication Preferences

I would like to receive emails.

*

Please select all that apply.

Yes No

I would like to receive text reminders.

*

Please select all that apply.

Yes No

Fees

If you prefer to pay via check, please make payable to: Highlands Emmaus Community and mail to: PO Box 16214, Bristol, VA 24209.

Team Fees: $175.00
Pilgrim Fees: $175.00
Private Room: $60.00
Sponsor a Pilgram: any amount

Fees

The deadline for submitting an application for a Walk is the Thursday PRIOR to the date of the Walk.

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

This application is for people that have already been a part of Walk to Emmaus.
(Do NOT give this form to the Pilgrim.)

Please Fix the Following

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