Online Application 2017-04-22T11:12:11+00:00

Online Application

Date of Arrival:
Time of Arrival:
Date of Departure:
Time of Departure:

Purpose Of This Visit:
Mission TripRetreatStudy or PlanRecreationOther

If Other Please Describe:

Number of Youth:

Number of Adults:

Overnight capacity is 22

Name of Group:

Name of Group Leader:





Alt Tel:

E-mail Address:

By clicking below I certify that I have read the guidelines for the use of the center; that we will do our best to abide by them; and that we will be responsible for any damages that our group may cause.
I/we understand that the ASMC is funded solely by donations. If our non-profit organization makes a cash donation, we will make advance arrangements for a receipt. Otherwise, if donating, we will present a check made out to St. Andrews-Covenant Presbyterian Church or will mail our check to:
St. Andrews-Covenant Presbyterian Church
c/o Catheryn Thomas, Ministry Secretary
1416 Market Street
Wilmington, NC 28401
I/we will provide a timely Certificate of Insurance as requested (most insurance agents understand what is needed and will respond quickly but if requested, ASMC will send a redacted Certificate as a sample).

Click To Accept Rules and Guidelines:

Please enter the characters below: