CURSILLO WEEKEND APPLICATION for Candidate
ENGLISH CURSILLO OF THE DIOCESE OF CAMDEN, NJ
"Cursillo - A Short Course in Christianity"

Today's Date (mm/dd/yy):   Sponsor's Name: Did your sponsor explain the weekend? Please Select Yes No

Please explain why you want to make a Cursillo weekend?:
Candidate: Please Select Female Male Age: Date of Birth (mm/dd/yy): Married: Please Select Yes No Religion: Please Select Catholic Not Catholic
Full Name: Name wanted on NameTag:
Address: City: State (ex.NJ): Zip: Phone #r:
E-mail: Parish Name and City:
Emergency Contact Name: Emergency Contact Phone #:

Explain any problems or detail any special needs we should be aware of (if there are none please type in NONE):
Diet: Physical:
Medical: Medicines:

Do you understand that this is an active, structured weekend rather than a "restful retreat"? Please Select Yes No
After the weekend, are you willing to continue in Cursillo with your Sponsor? Please Select Yes No

The cost of the weekend is $150.  A deposit must be submitted with the application.  The deposit will be returned if candidate does not make the weekend. A new application must be submitted as we do not hold any applications.  Make checks payable to: Diocese of Camden English Cursillo.  Mail To: Pat Wolfe, 706 Embassy Terr., Vineland, NJ 08360

I have read the entire application and have answered all of the questions to the best of my knowledge.  Please Select Yes No