Arizona 5 Day Academy 2022 AZ 5 Day Academy 2022 AZ 5 Day Academy pre-registration form for September 18-23, 2022. Name* First Last Mailing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Are you Clergy or Laity? Clergy Laity Gender Age Group Under 40 40 to 60 60 to 80+ What is your denomination/faith tradition? Are you a clergy member of the Desert Southwest Conference? Yes No I don't know Are you a lay member of a United Methodist Church in the Desert Southwest Conference? Yes No I don't know Have you been to an Academy for Spiritual Formation before? Yes No Have you completed the Two-Year Academy for Spiritual Formation? Yes No Room ChoicesRoommates need to register at the same time. Single Room ($875 before Aug 15) Double Room ($775 before Aug 15) Registration Payment (Select the option that you are ready to pay now.)*Double room only available for members of the same household. Roommates need to register at the same time. Rates go up by $100 after August 15. Single Room $875 - (before Aug 15) Double Room $775 - (before Aug 15) Hold my spot with a $200 refundable deposit Roommate Name First Last If you wish to apply for a scholarship, please contact Jerry Haas, retreat leader at firstname.lastname@example.org.Scholarship Interest IndicationDo you want to apply for a scholarship? Yes No Scholarship DonationAdditional funds are needed so that all who feel called to participate in this event may do so. If you are interested in donating, please select the option you prefer. I'm including an additional amount now with this registration. I’ll make a donation to this fund via check to Desert Southwest Conference, P.O. Box 32830, Phx, AZ 85064. Write “Academy scholarship fund” in the memo line. Scholarship Donation AmountPlease enter the amount you want to donate with your registration fee. Special Diet RequestPlease let us know if you have any dietary issues.NoneVegetarianVeganGluten SensitivityOther - Fill in belowPlease enter your diet request. Total to Pay Now $0.00 Credit CardCard Details Cardholder Name NameThis field is for validation purposes and should be left unchanged.