REQUEST A RETREAT

SERVICES OFFERED

We serve from our home because hospitality is a Selah Glen core value. Selah Glen is a retreat ministry and not a guest house. Retreats typically begin Monday evening at dinner and conclude Friday at noon. We build a retreat schedule to meet the needs of those seeking restoration, renewal, and refreshment. In addition to pastoral counseling, marriage counseling, and spiritual direction, we also offer individual and team debriefing.

APPLICATION

Please complete this application. If applying as a married couple, we request that both husband and wife each complete applications. If a question does not apply to your situation, answer N/A. If you wish to discuss your situation before applying or have questions, contact us, and we will schedule a phone appointment. The answers you provide are kept in strict confidence and assist us to know you better and to understand your needs.

First name

Last name

Phone

What is the best way to contact you?

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

How did you learn about Selah Glen's ministry?

When would you like to attend Selah Glen? (Dates are subject to availability.)

Describe your general physical health.

Do you have any food allergies?

Do you currently have any health issues, including mental health concerns?

Do you currently have thoughts of hurting yourself or taking your life?

What is the name of the organization, church, or place of ministry?

Describe your current ministry.

What provides you with the most ministry satisfaction?

What provides you with the least ministry satisfaction?

What are your patterns of rest?

How has your vocational calling impacted the quality of your relationships?

What are your sources of refreshment, personal growth, or creativity?

What do you hope to accomplish at Selah Glen?

Is there something you wish to add to the questions you’ve already answered?

Who is your emergency contact person?

What is their relationship to you?

What is his/her phone number?

Before continuing, please click the buttons below to access and read our Doctrinal Statement and Agreement to Receive Services.

DOCTRINAL STATEMENT

I have read and understand the Selah Glen Doctrinal Statement and consent to receive pastoral counseling and spiritual directing from Dennis Ahern and Denise Ahern from these theological reference points.

AGREEMENT TO RECEIVE SERVICES

I have read and understand the Selah Glen Agreement to Receive Services from Dennis Ahern and Denise Ahern. I understand and consent to comply with them.

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Today's Date

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restore, renew, and refresh