Registration Form NEW ONLINE2

Southwest Michigan DeColores Ministries, Inc.

Reinforcing individual commitment to Christ through piety, study, and action
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 section is to be completed by the candidate or sponsor:

THIS APPLICATION MUST BE COMPLETED IN FULL. APPLICATIONS THAT ARE ONLY HALF COMPLETE WILL BE REJECTED AND RETURNED. THANK YOU SO MUCH.
Candidate's Name*
Prefers to be called*
Candidate's Address*

Street Address

Street Address Line 2

City/State/ZipState / Province

Postal / Zip Code
Email*
Home Phone Number*
Cell Phone Number*
Sex:*

MaleFemale
Birthdate*

MonthDayYear
Date
Marital Status (Single, Married, Divorced, Widowed, Separated)*
If Married, Spouse's Name
Emergency Contact Name*
Emergency Contact Phone Number*
Church Name
Pastor's Name
Church Address

Street Address

Street Address Line 2

City/State/ZipState / Province

Postal / Zip Code
Please answer the following questions: Please Type your answer. If yes please explain.
Have you ever participated in a Three-Day Cursillo? IF yes, what was it called?*
Has a DeColores weekend been explained to you?*
Are there any medications you will need during the weekend? *
Do you have any food allergies? *
Do you have a health problem or physical handicap which requires special accommodations? If YES please explain*
This section is to be completed by the sponsor:
Sponsor's Name*
Weekend Made #*
Name of Three Day Cursillo (Ex: DeColores)*
Sponsor's Address*

Street Address

Street Address Line 2

City/State/ZipState / Province

Postal / Zip Code
Home Phone Number*
Cell Phone Number*
Email Address*
example@example.com
Please answer the following questions:
Have you explained the DeColores weekend to your candidate? (yes or no)*
Are you prepared to fulfill your sponsor duties stated in the Sponsors Convant?*
Are you receiving the Harvester Newsletter?*
Qualities that BEST describe your candidate. Type one or more of the following: Shy, Outgoing, Quiet, Talkative, Leader, Follower*
List other qualities (including their physical, emotional, and spiritual needs)*
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 sbmit this completed Registration Form and $50 payment online or print and send to: SWMI DeColores, P.O. Box 225, Niles, MI 49120, Attention: You can also find this form and pay online at www.swmi-decolores.org.
SWMI DeColores Privacy Policy
I have reviewed private policy above.*

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

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USDThe suggested amount is $50
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