Retreat Questionnaire (Hard Copy) - 15
Retreat Questionnaire (Hard Copy) - 15
QUESTIONNAIRE
…for those
who want to make a Monastic
Discernment Retreat at Mount Angel
Abbey
Date 07/09/14
Name Balentin Alfaro Have you ever used illegal drugs of any kind?
Age ________
39 DOB 06/21/76 yes,i use drugs 15 years ago,before my convertion to crist.
Citizenship mexican
Home Address 25 weber ave
Have you ever received professional psychological
Mailing Address counseling? If so, why? no
FAMILY
Father: Living or deceased? living
Religion catholic EDUCATIONAL BACKGROUND
Occupation retire Please indicate colleges/universities attended and
Mother: Living or deceased? deceased degrees earned: primary school
Religion
Occupation
Siblings 6
Parents’ marital status Have you ever attended another seminary, or have you
ever been in another religious community? If so, please
indicate: no
PHYSICAL/PSYCHOLOGICAL BACKGROUND
Do you have any physical handicaps or limitations?
no
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Have you ever been dismissed from a school, seminary Please indicate the frequency of your:
or religious community? If so, please explain: no Attendance at Mass: everyday
Have you ever been arrested? If so, please explain. Do you pray any of the Liturgy of the Hours (Divine
yes,15 years ago i was arrested drinking Office)? yes,l do.
VOCATION
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Have you ever been married? If so, please explain.
no
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AUTOBIOGRAPHY
Please use the remainder of this and the following page to
sketch a brief autobiography, including such information as
family background, significant relationships, your
education, your work history, your spiritual life and
vocational awareness, and any other pertinent information.
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