Online Weekend Application Form

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Online Weekend Application Form
- The maximum number of form submissions has been reached. This form is currently not available.
  
  Required Fields Must Be Completed - Notice that certain fields on this form are marked as REQUIRED. The form will not submit until all required fields are completed.
  
  CANDIDATE APPLICATION FORM
  
  This form can be used to apply for the following weekends:
  
  Men's 128 September 5-8, 2024
  
  Women's 118 October 17-20,2024
  
  Which weekend are you applying for? REQUIRED Men's 128 Women's 118 Please fill out this field.
  
  Candidate Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname on Badge Please enter valid data.
  
  Age REQUIRED Maximum 3 characters Please fill out this field. Please enter valid data.
  
  Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Home Phone Maximum 20 characters Please enter a phone number.
  
  Cell Phone Maximum 20 characters Please enter a phone number.
  
  Email Address REQUIRED Please fill out this field. Please enter an email address.
  
  Marital Status REQUIRED Please fill out this field.
  
  Present Employer Please enter valid data.
  
  Position Please enter valid data.
  
  Parish Name REQUIRED Please fill out this field. Please enter valid data.
  
  Parish City REQUIRED Please fill out this field. Please enter valid data.
  
  Special needs
  
  Where are you in your faith journey? REQUIRED Please fill out this field.
  
  Sponsor Name REQUIRED Please fill out this field. Please enter valid data.
  
  Sponsor Email REQUIRED Please fill out this field. Please enter an email address.
  
  Sponsor Cell Phone Number Maximum 20 characters Please enter a phone number.
  
  Emergency Contact Name REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Date REQUIRED Please fill out this field. Please enter valid data.
  
  PAYMENT OF THE DEPOSIT
  
  The Cursillo movement is a movement of the Church which by means of its own method makes it possible for
  people to live what is fundamental for being a Christian, and to live it together; it helps people discover and
  fulfill their personal vocations, and it promotes the creation of core groups of Christians who leaven their
  environments with the Gospel.” FI #111
  
  Instructions:
  
  We request that you pay the $25 deposit now using a credit card and we will collect the remainder by check or cash on Thursday night of the weekend.
  
  You can also pay the full amount now to save time at the registration table.
  
  If you cannot make a payment using a credit card now, you can pay the full amount at registration table.
  
  If you cannot cover your registration at this time, please indicate so and we will cover it for you using donations.
  
  Payment Amount REQUIRED 25.0 – Deposit paid by credit card 225.0 – Full amount paid by credit card 0.0 – Will pay full amount by check at registration 0.0 – Unable to pay Please fill out this field.
  
  Total:
  
  Submit
  
  Pay Now
  
  Pay Later
  
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Men's 128	September 5-8, 2024
Women's 118	October 17-20,2024