MTD Candidate Form

CANDIDATE FORM
Candidate weekend fee is: $165, payable to Minnesota Tres Dias (cash or check accepted) PLUS a $15 non-refundable fee to be paid by Sponsor, for a total of $180.

Please mail to: Minnesota Tres Dias, N4810 US Highway 63, Ellsworth, WI 54011
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState

Zip Code
Main Contact Phone Number

Area CodePhone Number
E-mail
This is where you will receive your confirmation
Church You Attend
Church City and State
Married?
Spouse Name

First NameLast Name
Spouse Main Contact Phone

Area CodePhone Number
Have you been through a Tres Dias or Cursillo or Emmaus Weekend?
Has your Spouse been through a Tres Dias or Cursillo or Emmaus Weekend?
Weekend Signing Up For?
Emergency Contact Name
Emergency Contact Main Phone Number

Area CodePhone Number
Relationship with Emergency Contact
Your Birthdate (MUST BE 21+ to attend)

MonthDayYear
Are you a smoker?
Any Special Needs You May Have? Food Allergies, Physical Limitations etc?
Sponsor Information
Sponsor Name
Sponsor Main Phone Number

Area CodePhone Number
Sponsor E-mail
Please Note: This application must be accompanied by the Sponsor Fee to secure your spot on the weekend. Please contact your Sponsor if you have any questions.
Should be Empty:

CANDIDATE FORM