Online Weekend Application Form

Please read before completing this form.

Required Fields Must Be Completed	If the form is still there after clicking on "Proceed To Payment" button, look for a field with "Please complete this field" or some other error message in red below it. Complete or correct the field and try again.
Credit Card Required	You will be prompted for credit card information after you click the "Proceed To Payment" button.
Confirmation Emails	Confirmation emails will be sent to the candidate and the sponsor when the submisson is complete.

Weekend Information

Men's 122 March 5-8,2020

Women's 112 March 19-22, 2020
Which weekend are you applying for? REQUIRED Men's 122 Women's 112 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 for badge (if different than first name)
Nickname Please enter valid data.
Age REQUIRED 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.
Candidate Phone 1 REQUIRED Please fill out this field. Please enter a phone number.
Candidate Phone 2 Please enter a phone number.
Email Address REQUIRED Please fill out this field. Please enter an email address.
A confirmation email will be sent to the email address above.
Verify Email Address REQUIRED Please fill out this field. Please enter an email address.
Why are you interested in attending a Cursillo weekend? REQUIRED Please fill out this field.
Organization to which you belong (religious, social, professional, etc.)
Organizations
Hobbies or interests
Employment Status REQUIRED Employed Unemployed Retired Please fill out this field.
If employed or previously employed:

Employer Please enter valid data.

Position Please enter valid data.

Candidate Parish

Spouse Information

Special Instructions

Sponsor 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.
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.
Sponsor Phone 1 REQUIRED Please fill out this field. Please enter a phone number.
Sponsor Phone 2 Please enter a phone number.
Sponsor Email REQUIRED Please fill out this field. Please enter an email address.
A confirmation email will be sent to the email address above.
Verify Email Address REQUIRED
Please retype email address
Please fill out this field. Please enter an email address.
Sponsor Parish Name & City Please enter valid data.
How long have you known this candidate? (Specify a number plus days, weeks, months or years.)
How long known? REQUIRED Please fill out this field. Please enter valid data.

Payment of the Deposit

Instructions:
1. We request that you pay the $25 deposit now using a credit card.
2. We will collect the remainder by check or cash on Thursday night of the weekend.
3. You can also pay the full amount now to save time at the registration table.
Payment Amount REQUIRED 25 – Deposit 125 – Full amount Please fill out this field.

Men's 122	March 5-8,2020
Women's 112	March 19-22, 2020