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Request Information

We deeply regret that due to technical problems, Information Requests submitted between December 12, 2007 and January 31, 2008 were not received.  We regret any inconvenience this may have caused.  For information regarding residency at Pilgrim Place, please re-submit the form below or contact Janet Cromwell, Director of Admission, at 909-399-5504 or jcromwell@pilgrimplace.org.

Thank you for your interest in Pilgrim Place!

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

Name
Address
City   State   Zip
Phone
Email

Denomination/ Church Affiliation


Check all that apply:

Please send information about Pilgrim Place.

Please send me an Application Form.

Please add me to your 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 type of Christian service in which you have been involved (i.e. local church, missionary, teaching, etc.):

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

Your desired year of entrance to Pilgrim Place:

How you became aware of Pilgrim Place:

Residents you know at Pilgrim Place: