Candidate Registration Form

Southwest Michigan DeColores Ministries
DeColores Ministries is open to all denominations. Candidates attending must be 19 years or older. All information is kept confidential, not sold, or used outside of our DeColores community.

This application must be completed in full. Any application not fully complete at time of submission will be rejected and returned. Thank you so much.
Candidate's Information
Name*
Prefers to be called*
Candidate's Address*

Street Address

Street Address Line 2

City/State/ZipState / Province

Postal / Zip Code
Phone Number*
Email Address*
Candidate's Birthdate*

MonthDayYear
Date
Sex*

MaleFemale
Candidate's Marital Status (Single, Married, Divorced, Widowed, Separated)*
If Married, Spouse's Name
Emergency Contact Name*
Emergency Contact Phone Number*
Home Church (include city and state)
Pastor's Name
Have you ever participated in a Three-Day Cursillo? If yes, what was it called?*
Do you have any food allergies? *
Are you taking special medications?*
Do you have a health issue/physical handicap which requires accommodations? If yes, please explain.*
To be completed by the Sponsor
Name*
Weekend #*
Name of Cursillo (Ex: DeColores)*
Street Address*

Street Address

Street Address Line 2

City/State/ZipState / Province

Postal / Zip Code
Phone Number*
Email Address*
example@example.com
Have you explained the DeColores weekend to your candidate?

YesNo
Are you prepared to fulfill your sponsor duties stated in the Sponsor's Covenant?

YesNo
Are you receiving The Harvester (our semi-annual newsletter)?

YesNo
Are you receiving The Harvester (our semi-annual newsletter)?*
Qualities that best describe your candidate. Type one or more of the following: Shy, Outgoing, Quiet, Talkative, Leader, Follower*
PLEASE NOTE: The $50 non-refundable candidate fee can be paid by sponsor or candidate. If your candidate turns down three invitations to attend a weekend, new forms and fee must be submitted. You are not allowed to sponsor more than 2 candidates per weekend, as you have many responsibilities. Registrations are processed in the order they are received.

TO REGISTER: You must submit this completed Registration Form and $50 payment online or print and send to: SWMI DeColores, PO Box 225 Niles, MI 49120.

You can also find this form and pay online at www.swmi-decolores.org.
SWMI DeColores Privacy Policy
I have reviewed privacy policy above.*

Yes
Online Payment Candidate Fee (Place 0 if paying at registration)

prevnext( X )
USDThe suggested amount is $50
List other information (including their physical, emotional, and spiritual needs)*
Should be Empty:

Candidate's Information

To be completed by the Sponsor