Daytime Number
xxx-xxx-xxxx
Do you have any health concerns which we
need to know about for your weekend?
If not, is your spouse scheduled to attend a weekend?
Who has spoken to you about Cursillo and
encouraged  you to apply to attend a weekend?
The person identified above is your sponsor.  Has your
sponsor explained the purpose, method, and strategy of the
Cursillo Movement, to include Group Reunions and Ultreya?
HOME
APPLICANT IDENTIFICATION INFORMATION
First name
 Last name
 Nickname
Age
Date of Birth
# Children
CONTACT INFORMATION
M a i l i n g   A d d r e s s
E-mail Address
Address Line 1
Address Line 2
State
 ZIP
City
T e l e p h o n e  N u m b e r s
Evening Number
xxx-xxx-xxxx
Mobile Number
xxx-xxx-xxxx
H o m e  P a r i s h
Name of Parish
 City
State
For your own well being we need to know:
If "Yes" please explain below:
Are you on a restricted diet?
If "Yes" please explain below:
About your Spouse:
Has your spouse attended a Cursillo Weekend?
If "Yes" please give details below:
If "Yes" please give details below:
Your current knowledge of Cursillo
Comments: