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.

Please PRINT CLEARLY and fill in all the blanks.

This section is to be completed by the candidate or sponsor:

Candidate's Name

Prefers to be called

Candidate's Address

Street Address

Street Address Line 2

City/State/Zip

Email

Home Phone Number

Cell Phone Number

Sex:

Male Female

Birthdate

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/Zip

Please answer the following questions: Yes No (Please write on the back of this form if you require more room)

Have you ever participated in a Three Day Cursillo? If yes, what was it called?

Do you have any food allergies? If yes, please explain.

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/Zip

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 send this completed Registration Form and $50 payment to: SWMI DeColores, P.O. Box 225, Niles, MI 49120, Attention: Pre-DeColores. You can also complete this form and pay online at www.swmi-decolores.org.

Online Payment Candidate Fee

USD The suggested amount is $50