Please complete the following electronic form and send it via the "submit" button at the bottom
of this page. Alternatively, you may print an application and mail it to us directly, please click here for the printable application.
Are you returning Alumni of Genesee Home?
- If yes, please make your request via our special Alumni Request Form.
   
* indicates a required field
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* Please tell us how you heard about Genesee Home. We want to be good stewards of Genesee Home's funds and value your answer to this question so we
can best direct our marketing efforts. Please check all that apply:
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| # of Past Visits to GH: |
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| * Your Full Name: |
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| * Spouse's Full Name: |
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| * Anniversary Date: |
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| * Husband's Birthdate: |
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| * Wife's Birthdate: |
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| * Size of Family: |
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| * College, University or Bible College Attended: |
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* Seminary Attended:
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| * Additional Graduate School: |
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| * Mailing Address: |
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* Home Address 2:
* If different from above. |
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| * City: |
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| * State: |
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| * Zip Code: |
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| please enter 10-digit phone numbers without spaces or dashes, e.g 5302841082 |
| * Home Phone: |
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| * Work Phone: |
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| * Email: |
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| * Confirm Email: |
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| * Spouse's Email: |
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| * Church/Ministry Name: |
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| * Average Attendance: |
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| * Denomination: |
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| * Year Your Minsitry Began: |
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| * Your Position: |
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| * Descrition of your Ministry: |
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* Special Needs:
Food allergies, diabetic, vegetarian, etc, please explain fully.
If you would like to speak directly with the chef, you may email her via:
chef@geneseehome.org |
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* Other Special Needs:
Please explain anything that may help us accomodate any special needs. |
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| * Emergency Contact Name: |
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| * Contact's Phone Number: |
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Genesee Home Calendar
When the calendar indicates 1 or 2 rooms available these are usually our queen bedrooms: Garden and Hosselkus. All other dates that are open will have at least three rooms available. Please call to be put on our waiting list.
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January 2010 |
February 2010 |
March 2010 |
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April 2010 |
May 2010 |
June 2010 |
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July 2010 |
August 2010 |
September 2010 |
04 - 09
11 - 16
18 - 23*** |
15 - 20 ****
22 - 27***
29 - Sept 3
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05 - 10
12 - 17
19 - 24
26 - Oct 1
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October 2010 |
November 2010 |
December 2010 |
3 - 8
10 - 15
17 - 22
24 - 29
31 - Nov 5
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7 - 12
14 - 19
28 - Dec 3
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5 - 9
12 - 17
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For Available Dates in 2011:
You may call (530).284.1082 or (866) 715-REST
or email Genesee Home
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* Special Valentine's Week
** Special Alumni Week
*** 1 Room Available
**** 2 Rooms Available
If you are interested in being on our waiting list for a week that is not listed, Please call:
1-866-715-REST.
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PREFERRED DATES: Please choose 3 dates in order of preference and we'll make every effort to accomodate your first choice, but would like to respond with others if it is unavailable. All dates are Sunday - Friday.
Please note: You should plan to arrive after 3:00 PM on Sunday afternoon and before 6:00- PM and depart after 11:00 AM on the following Friday.
A determination email will be sent within 48 hours of our receipt of your request.
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| * 1st Choice: |
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| * 2nd Choice: |
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| * 3rd Choice: |
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| Indicate in the comment box below if your selected dates are of particular importance. |
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Garden Room
258 ft²
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Genesee Room
365 ft²
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Hosselkus Room
321 ft²
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Meadow Room
426 ft²
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Parlor Room
417 ft²
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Please list your 1st, 2nd, and 3rd choice of accommodations. We will do our best to honor your choice of room; however, rooms are assigned on a "first come-first serve" basis.
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| * 1st Room Choice: |
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| * 2nd Room Choice: |
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| * 3rd Room Choice: |
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| Indicate in the comment box below if your selected rooms are of particular importance. |
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| Do you intend to coordinate your visit with any other individuals?
Yes
No
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| * If Yes, Provide Name: |
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| How will you be traveling to Genesee Home?
By Car
By Plane
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SCHOLARSHIP OPPORTUNITIES
The Board of Genesee Home offers limited scholarship help for couples who need assistance in visiting Genesee Home. By clicking the following checkbox, any information currenly recorded in this form will be submitted to us electronically via the submit button at the bottom of the page, afterwhich you will be forwarded to the Scholarship Request Form to complete your scholarship application.
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Yes, after I submit this form I would like to apply for a scholarship.
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| * Please briefly describe your Sabbath week desires at Genesee Home:
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| Comments:
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We are unable to accommodate children or pets. A visit to Genesee Home is not intended to be a vacation; it is a restful setting where you and your spouse can be refreshed, restored and renewed through time alone, time with God and interaction with each other.
Before you submit your request, please read and acknowledge your agreement with our Statement of Faith. (link opens a new window so you will not lose any entered data on this form)
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Yes, I agree with Genesee Home's Statement of Faith.
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| * Please Initial: |
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| Submission of a request by electronic medium constitutes your acknowledgement. |
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To ensure proper delivery of our confirmation emails, please add ministrydirector@gh.org and Charley@gh.org to your email safe-list so it is not unnecessarily filtered from your inbox or treated like spam/junk mail. |
