Please tell us how you heard about Genesee Home? We want to be good stewards of Genesee Home funds and value your answer to this question so we
can best direct our marketing efforts. Please check all that apply:

Presentation by our Directors, the Blom's

Personal Reference - please give us their name

Reference from GH Alumni - please give us their name

Returning Alumni of Genesee Home
Genesee Home Brochure
Genesee Home Website
Advertisement in Just Between Us Magazine

Article in Just Between Us Magazine

Raven Ministries

District Supervisior/Minister

Jill Briscoe Postcard
Spring and/or Fall Kenton Beshore Postcard
PostCard Name:

Other

How many times have you been to Genesee Home?



Your Full Name: * (indicates required field)
Spouse's Full Name: *
Anniversary Date: / / * (00/00/0000)
Husband Birthdate: / / (00/00/0000)
Wife Birthdate: / / (00/00/0000)
Size of Family:
Street Address: *
City: *
State: *
Zip Code: *

Please enter all Phone Numbers as one number.
for example : 5302841082
Home Phone: *
Work Phone:
E-mail: *

Church/Ministry Name: *
Average Weekend Attendance: *
Denomination:
Year of Ordination: *

Your Position: *
Description of your full time Ministry: *


While you are here, who would we contact in case of an emergency: *
PHONE: *

SPECIAL NEEDS: (food allergies, diabetic, vegetarian, etc.) please fully explain.

Food:


Other:

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.

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.

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.

1st choice: 6/29/2008 7/6/2008 8/3/2008 8/10/2008 8/17/2008 8/24/2008 8/31/2008 9/7/2008 9/14/2008 9/21/2008 9/28/2008 10/5/2008 10/12/2008 10/19/2008 10/26/2008 11/2/2008 11/9/2008 11/16/2008 11/30/2008 12/7/2008 12/14/2008
2nd choice: 6/29/2008 7/6/2008 8/3/2008 8/10/2008 8/17/2008 8/24/2008 8/31/2008 9/7/2008 9/14/2008 9/21/2008 9/28/2008 10/5/2008 10/12/2008 10/19/2008 10/26/2008 11/2/2008 11/9/2008 11/16/2008 11/30/2008 12/7/2008 12/14/2008
3rd choice: 6/29/2008 7/6/2008 8/3/2008 8/10/2008 8/17/2008 8/24/2008 8/31/2008 9/7/2008 9/14/2008 9/21/2008 9/28/2008 10/5/2008 10/12/2008 10/19/2008 10/26/2008 11/2/2008 11/9/2008 11/16/2008 11/30/2008 12/7/2008 12/14/2008

Please indicate in the comment section below if the Date or Room choice is most important to you.

Do you intend to coordinate your visit with any other individuals?
yes no
Name:

TRANSPORTATION:
Please tell us how you plan to arrive for your visit at Genesee
Home:
Driving
By Air into Reno Airport

EXPENSE REIMBURSEMENT :
The majority of Genesee Home expenses are covered by donations in order to reduce the cost passed along to the guests. The cost to you generally reflects only about 1/3 of Genesee Home's operating costs, and is to cover reimbursement for meals served and other expenses. A week's visit to Genesee Home costs $395.00 per room which includes lodging, all meals and recreation.

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.

ROOM (click on room to view a picture of the room and a description of its amenities)
Garden Room 258 sq. ft.
Genesee Room 365 sq. ft.
Hosselkus Room 321 sq. ft.
Meadow Room 426 sq. ft.
Parlor Room 417 sq. ft

1st Choice: Garden Room Genesee Room Hosselkus Room Meadow Room Parlor Room
2nd Choice: Garden Room Genesee Room Hosselkus Room Meadow Room Parlor Room
3rd Choice: Garden Room Genesee Room Hosselkus Room Meadow Room Parlor Room

SCHOLARSHIP OPPORTUNITIES
The Board of Genesee Home offers limited scholarship help for Couples who need assistance in visiting Genesee Home.

Yes, I will apply on the Scholarship page

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.

Please tell us briefly what your desires are for your Sabbaath week at Genesee Home. *

Before you submit your request for a visit, please read our Statement of Faith and acknowledge your agreement with its content.

I have read Genesee Home's Statement of Faith and I am in agreement with its content. (please initial) *

Comments:

Submission of a request by electronic medium constitutes your acknowledgement.