Ottawa Cursillo Candidate Application
Cursillo is a method of personally encountering God, building one's faith, and encouraging participants to spread the Gospel of Jesus Christ through evangelization of their environments. Please fill out this application as completely as possible. The Weekend's Registrar, Roxanne Leblanc-Lemieux will be in touch with you approximately 6 weeks before the weekend date. If you would like to get in touch with Roxanne, her email address is roxanne-leblanc@rogers.com. You will be required to include your Weekend Sponsor's name. If you do not yet have a Sponsor please contact Roxanne for assistance.
* denotes a mandatory field
Date
-
Month
-
Day
Year
Date
I am applying for:
*
Men's Weekend
Women's Weekend
Applicant Information
Name
*
First Name
Middle Name
Last Name
Please indicate your name as you would like it shown on your name badge
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Home Phone
*
Please enter a valid phone number.
Alternate Phone
Please enter a valid phone number.
Spouse's Name
First Name
Last Name
Has your spouse completed a Cursillo weekend?
Yes
No
When
Where
Marital Status
*
Married
Single
Widowed
Separated
Divorced / Annuled
Marital Status Year
Married in the Catholic Faith?
Yes
No
Home Parish
*
Age group
*
21-30
31-40
41-50
51-60
61-70
71+
Are you Catholic?
*
Yes
Other
Do you have a Sponsor?
*
Yes
No
Sponsor's Name
First Name
Last Name
Sponsor's Phone
Please enter a valid phone number.
Sponsor's Email
example@example.com
Sponsor's Parish
Relationship to Sponsor
Do you know someone who has made a Cursillo?
How did you hear about Cursillo?
Please indicate any physical limitations
Please indicate any health issues
Please identity any dietary or allergy concerns
Emergency Contact
First Name
Last Name
Emergency Contact Phone
Please enter a valid phone number.
Please verify that you are human
*
Submit
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