Login Username:
First Name:
Last Name:
Address:
City:
State:
Zip:
Cell Phone:
Home Phone:
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Email:
Birth Date:
(click on the datepicker "Month Year" on top to choose the date quicker)
Gender:
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Male
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List any physical or medical limitations:
List any dietary limitations:
Musical Instruments Played:
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I am a Singer
Other Talents:
Occupation:
Marital Status:
Unknown
Married
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Separated
Single
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Spouse's Cursillo Information
(Is your spouse applying at this time? Has your spouse made Cursillo? If Yes, enter Spouse's Name, when, where)
How did you hear about Cursillo?
Why do you want to attend a Catholic Cursillo Weekend?
Religion:
I am Catholic
Denomination:
Parish Name:
Not Applicable Outside of Diocese All Souls Ascension Assumption of Mary (Croatian) Assumption Bethel Temple Catholic Community at Stanford Chinese Catholic Community Chinese Catholic Mission (SJ) Christ Child Christ the King Christian Center CrossWinds Church (San Ramon) Epiphany Evergreen/Edenvale Five Wounds Greek Orthodox Holy Cross (Santa Cruz) Holy Family Holy Korean Martyrs Holy Spirit Holy Trinity (El Dorado Hills) Korean Catholic Mission Mercy Hill Church Mission Santa Clara Mitty Chapel Most Holy Trinity New Creation Lutheran Newman Center Oak Hill (Folsum) Our Lady of Guadalupe Our Lady of Loretto Our Lady of Peace Our Lady of Refuge Our Lady of Sierra Our Lady, Star of the Sea (Santa Cruz) Queen of Apostles Queen of Martyrs Resurrection (Aptos) Resurrection (Sunnyvale) SS Peter and Paul Sacred Heart (SJ) Sacred Heart (Salinas) Sacred Heart (Saratoga) Sacred Heart (Washington) San Agustin (Scotts Valley) San Francisco San Juan Baptista Mission Santa Teresa St Andrew & Paul (Korean) St Andrew St Ann St Anthony Padua (Manteca) St Anthony St Athanasius St Augustine (Scotts Valley) St Barthelomew St Benedict (Hollister) St Brother Albert St Catherine (Morgan Hill) St Catherine St Christopher St Clare St Cyprian St Dominic St Edward St Elizabeth St Frances Cabrini St Francis of Assisi St Gregory St Joan of Arc St John Vianney St John the Baptist St Johns (Folsum) St Joseph (Capitola) St Joseph (Cupertino) St Joseph (Fremont) St Joseph (Los Banos) St Joseph (Mtn View) St Joseph Cathedral St Jude St Julie Billiart St Justin St Lawrence (Oakland) St Lawrence (Sacramento) St Lawrence Martyr St Lawrence St Leo the Great St Lucy St Maria Goretti St Mark St Martin (Sunnyvale) St Martin of Tours St Mary (Gilroy) St Mary (Los Gatos) St Michael (Pleasanton) St Michael St Nicholas St Patrick (Aptos) St Patrick St Pats (Sonora) St Paul (Fresno) St Rita St Simon St Stanislause (Modesto) St Thomas Aquinas St Thomas of Canterbury St Victor St Vladimire (Ukranian) St William Stanford Star of the Sea Transfiguration Valley Church (Watsonville) Vietnamese Mission
Attendance:
If “Outside of Diocese”, what is the church name?
Religious Order:
I am Religious (Priest, Deacon, Sister, Brother)
(select)
Priest
Deacon
Religious Sister
Religious Brother
None of These
Order:
Cursillo Weekend:
Select Date
What questions might you have for us:
Comments:
Sponsor:
I have a sponsor