ST.

JOSEPH SPIRITUALITY CENTER

2980 Kleinert Ave., Baton Rouge, LA 70806
Phone: 225-383-3349 E-mail: dianne@stjocenter.org
THE CENTER IS SPONSORED BY THE CONGREGATION OF ST. JOSEPH

APPLICATION FOR SPIRITUAL DIRECTION

Name: ________________________________Previous spiritual direction: Yes or No

If so, how long: ______________

Address: ______________________________________________________________________

City/State/Zip Code: ____________________________________________________________

Daytime phone: ( ) _____________________ Evening phone: ( ) _____________________

Email: _______________________________________________________________________

Date of Birth: ___________________________ Religious affiliation: _____________________

Married/Single/Other: ______________________ Spouse’s name: ________________________

Number and ages of children, if any: ________________________________________________

Briefly describe your spiritual life and how you nurture it _______________________________

______________________________________________________________________________

______________________________________________________________________________

What makes it important for you to seek spiritual direction at this time? ____________________

______________________________________________________________________________

______________________________________________________________________________

Days and times most convenient for regular periodic meetings with your director: ____________

______________________________________________________________________________

How did you hear about St. Joseph Spirituality Center? _________________________________

______________________________________________________________________________

Date: _______________________ Signed: ___________________________________________

(Directee)
Spiritual Director: ___Melinda LeBlanc ___Dana Territo ___Carmen Smith ___Faye Coorpender
Suggested Fee for Spiritual Direction is $40 per visit.
Please let your director know if a reduced fee or scholarship is needed.