Cursillo Candidate Registration Form

Cursillo Candidate Registration Form

Southern Missouri Cursillo, PO Box 1105, Cape Girardeau, MO 63702
Weekend*

Men's Fredericktown - February 26-March 1, 2026Women's Fredericktown - March 19-22, 2026Women's Carthage - April 23-26, 2026
Candidate Name*

First Name (Called)Middle NameLast Name
Parish, Town*
Candidate Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Birth Date

MonthDayYear
Gender*
E-mail*
Mobile Number

Area CodePhone Number
Highest Education Completed
Marital Status
If Married, is Spouse Catholic?

YesNo
Married in the Catholic Church?

YesNo
Why do you wish to make a Cursillo?
List any situations that would require special attention such as health, diet, disabilities, allergies, problems with stairs, etc
Activities you are currently involved in such as parish ministries, civic, professional, hobbies, etc.
Do you have any questions about Cursillo that your sponsor has not been able to answer? Do you have questions about Group Reunion and Ultreya?
Emergency Contact name*

First NameLast Name
Emergency Contact Phone Number*

Area CodePhone Number
Sponsor Name

First NameLast Name
Sponsor E-Mail
example@example.com
Sponsor Mobile Number*

Area CodePhone Number
Have you read and understood "Cursillo, What Is It?"
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