Retreat Request Form

Please complete the following form. If you require help completing this form or have questions, please contact the Retreat Coordinator at (800) 473-2649 ext 103 or retreats@sinfonia.org.

Name

Office


SELECT CHAPTERAlpha Beta Alpha Chi Alpha Gamma Alpha Iota Alpha Kappa Alpha Lambda Alpha Omicron Alpha Rho Alpha Sigma Alpha Theta Alpha Xi Alpha Zeta Atlanta Area Baltimore Area Beta Delta Beta Iota Beta Kappa Beta Lambda Beta Mu Beta Nu Beta Omicron Beta Pi Beta Psi Beta Sigma Beta Tau Beta Theta Beta Xi Central Florida Central Ohio Chicago Area Coastal Georgia Dallas/Ft Worth Delaware Beta Colony Delta Delta Epsilon Delta Eta Delta Iota Delta Lambda Delta Mu Delta Nu Delta Omega Delta Pi Delta Psi Delta Sigma Delta Tau Delta Zeta Epsilon Epsilon Alpha Epsilon Delta Epsilon Gamma Epsilon Iota Epsilon Kappa Epsilon Lambda Epsilon Nu Epsilon Omicron Epsilon Phi Epsilon Pi Colony Epsilon Rho Epsilon Sigma Epsilon Upsilon Eta Alpha Eta Beta Eta Gamma Eta Iota Eta Mu Eta Nu Eta Omega Eta Phi Colony Eta Xi Eta-Omicron Florida Iota Colony Florida Theta Colony Gamma Alpha Gamma Beta Gamma Delta Gamma Epsilon Gamma Eta Gamma Iota Gamma Omega Gamma Phi Gamma Pi Gamma Rho Gamma Theta Gamma Xi Gamma Zeta Greater Houston Indiana Gamma Colony Iota Iota Alpha Iota Beta Iota Epsilon Iota Gamma Iota Kappa Iota Mu Iota Nu Iota Omicron Iota Phi Colony Iota Pi Iota Psi Iota Rho Iota Tau Kappa Chi Kappa Eta Kappa Gamma Kappa Iota Kappa Omicron Kappa Psi Kappa Sigma Kappa Xi Kappa Zeta Lambda Beta Lambda Gamma Lambda Mu Lambda Phi Lambda Rho Lambda Sigma Lambda Xi Los Angeles Area Milwaukee Area Mu Mu Alpha Colony Mu Beta Mu Delta Mu Eta Mu Gamma Mu Nu Mu Omicron Mu Psi Mu Theta Mu Xi Nashville Area New York City Northeast Alabama Nu Eta Nu Gamma Nu Iota Nu Kappa Nu Lambda Nu Omicron Nu Pi Nu Psi Nu Sigma Nu Theta Nu Upsilon Nu Zeta Omicron Alpha Omicron Beta Omicron Delta Omicron Epsilon Omicron Gamma Omicron Iota Omicron Kappa Omicron Lambda Omicron Mu Omicron Nu Omicron Omega Omicron Phi Omicron Pi Omicron Psi Omicron Rho Omicron Tau Omicron Theta Omicron Upsilon Omicron Zeta Orange County Phi Phi Omega Pi Pi Beta Pi Chi Pi Delta Pi Eta Pi Gamma Pi Iota Pi Kappa Pi Mu Pi Nu Colony Pi Omicron Pi Psi Pi Rho Pi Sigma Pi Upsilon Pi Xi Pi Zeta Pittsburgh Area Rho Alpha Rho Beta Rho Chi Rho Delta Rho Epsilon Rho Eta Rho Gamma Rho Iota Rho Kappa Rho Lambda Rho Mu Rho Omega Colony Rho Omicron Rho Pi Rho Sigma Rho Tau Rho Theta Rho Upsilon Rho Xi Rho Zeta San Antonio Area Sigma Alpha Sigma Beta Sigma Chi Sigma Delta Sigma Epsilon Sigma Gamma Sigma Omega Sigma Psi St. Louis Area Tampa Bay Tau Tau Phi Texas Eta Colony Texas Theta Colony Theta Theta Iota Theta Lambda Theta Nu Theta Phi Theta Pi Theta Rho Theta Sigma Theta Tau Theta Upsilon Upsilon Upsilon Chi Upsilon Phi Upsilon Psi Virginia Epsilon Colony Washington DC Xi Xi Alpha Xi Delta Xi Epsilon Xi Eta Xi Gamma Xi Kappa Xi Lambda Xi Mu Xi Nu Xi Omega Xi Omicron Xi Pi Xi Sigma Colony Xi Tau Xi Theta Xi Upsilon Xi Zeta Zeta Zeta Alpha Zeta Beta Zeta Epsilon Zeta Eta Zeta Gamma Zeta Iota Zeta Kappa Zeta Mu Zeta Omega Zeta Omicron Zeta Psi Zeta Rho Zeta Sigma Zeta Tau

Email

Phone


Address

Line 1
Line 2
Line 3
City		State		Zip

What type of reservation/visit is this?

Weekend Retreat - Chapter/Colony
Weekday Retreat - Chapter/Colony
Weekend Retreat - Province
Weekday Retreat - Province
Province Event

If requesting a overnight or short day-visit, would you like:

Lyrecrest/National Archive Tour
Sinfonia Store Purchase
Other:  

Dates: NO WEEKEND DATES AVAILABLE

Other date(s): availability not guaranteed

Estimated time of arrival: AM PM

Estimated time of departure: AM PM

Has a retreat been discussed and significant interest established within the chapter/colony?
Yes
No

Purpose of retreat/visit


Are you willing to share these dates with another group which has similar retreat goals?
Yes
No

Number of probationary members attending:

Anticipated total number attending:
Chapters/colonies having full attendance on a retreat greatly increases the success of the event. Any chapter bringing 100% of their membership will receive a $50 certificate to the Sinfonia Store.

Would you like to do a Mills Music Mission while at Lyrecrest?
Yes
No

Any other comments, questions, or request?