LOUISIANA UNITED METHODIST CURSILLO

PILGRIM APPLICATION

 

 

Please Print

Circle one:     Mr.       Mrs.     Miss    Ms.   Rev.     Dr.

 

Name______________________________________________ Preferred Name____________________

 

Address___________________________________________ City_______________________________

State_______ Zip______________                     Home Phone (____)_______________________________

Work Phone (____) ______________________  Fax Number (____) _____________________________

E-Mail Address________________________________________________________________________

Occupation__________________________________Company_________________________________

 

Marital Status--Circle one    M         S         W        D         Birth Date _____________ No. of Children _______

 

Church, City_____________________________________ Pastor's Name:_________________________

 

Are you a Ordained Elder or Local Pastor?  ______       If "Yes", cirlce one:   Elder                 Local Pastor

 

In what religious or community organizations are you active?____________________________________

____________________________________________________________________________________

What are your hobbies?_________________________________________________________________

Are you on a special diet?______If so, explain:_______________________________________________

Low fat:__________ Low Salt:___________ Food Allergy:__________________ Diabetic:____________

Do you have any health problem or physical disability that will affect the preparation for your

attending a Cursillo Weekend?  If so, explain:________________________________________________

State briefly what you hope for and expect to receive from your Cursillo Weekend:___________________

____________________________________________________________________________________

 

Your Signature _____________________________________________ Date______________________

 

Pastor's Signature ______________________________________________________________

 

Sponsor's Signature ____________________________________ 

Cursillo No_______________

 

Sponsor's Address _____________________________________________________________________

 

All of the above information is necessary for your invitation to a Cursillo Weekend.  Please indicate which time of the year would best suit your schedule.  We make every effort to honor your choice.  However, because so many wish to attend, this is not always possible.  A representative of the Selection Committee will call you when there is a position available for a weekend.  Please speak with your sponsor to see if you may qualify for a standby position.

 

_____ Winter (Dec, Jan, Feb)                                 _____ Summer (Jun, Jul, Aug)

_____ Spring (Mar, Apr, May)                                 _____ Fall (Sept, Oct, Nov)

_____ Anytime                                                          _____ Standby (Able to come on short notice)

 

Please return to your sponsor with the Application Fee.

 

 Cost of the weekend: $150.00  (Includes all meals and lodging)      Please submit a nonrefundable

$50.00 Application Fee.

 

____ Check here to receive information on scholarships.