Cursillo Candidate Registration Form

Cursillo Candidate Registration Form

Southern Missouri Cursillo, PO Box 1105, Cape Girardeau, MO 63702
Weekend
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?
Married in the Catholic Church?
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?"
Should be Empty: