Fort Hood / Heart of Texas Cursillista
Membership Registration / Update Form
PRINT OUT AND MAIL IN VERSION
FIRST TIME TO FILL OUT THIS REGISTRATION FORM
___
OR
UPDATE ON PREVIOUSLY SUBMITTED REGISTRATION
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LAST NAME
FIRST NAME
________________________
________________________
MAILING
ADDRESS
________________________
________________________
CITY
STATE
ZIP
_____________________________
_______
_______________
HOME PARISH
NAME
________________________________________________
CITY
STATE
_____________________________
_______
AREA + PREFIX + NUMBER
HOME PHONE
WORK PHONE
___________________
___________________
CURSILLO DATE
OTHER PHONE
___________________
___________________
If there is anything else you'd like to tell us about yourself or your family, use the space below.
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MAIL
TO:
Cursillo Membership Update
2205 Armadillo Drive
Killeen, TX  76549
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