Request Information

To request a full-color brochure and Application Packet, please fill out the form the below:

City   State   Zip

Do you inted to bring a pet to Pilgrim Place?  What kind?

Check all that apply:

Please send me information about Pilgrim Place.

Please send me an Application Form.

Please add me to your monthly e-Newsletter mailing list.

Please call me. I want to discuss retiring at Pilgrim Place.

Please contact me. I would like to arrange a campus tour. 

The following information assists the Admissions Office in arranging your visit on campus.  Please tell us about:

The religious, charitable, and/or non-profit humanitarian organizations (i.e. churches, missions, seminaries, non-profit peace and justice organizations, etc.)  in which you have been employed:

Your age group: 
Under 62
62-69 years old
70-77 years old 

Your anticipated desired year of entrance to Pilgrim Place:

How you became aware of Pilgrim Place:

Residents you know at Pilgrim Place:

Thank you for your interest in Pilgrim Place!  If you have questions or wish to arrange a        campus visit, please contact:  Gisele Tackoor, Director of Admission, at 909-399-5504 or