Phone (______) ______-________ Date of Birth ____________ Marital Status __________________

E-Mail Address _______________________________ Occupation ___________________________

Parish _______________________________________ Location _____________________________

Church/Community Activities _________________________________________________________

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Renewal Programs Attended __________________________________________________________

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Health/Mobility Problems/

 Sponsor’s Name ____________________________________________________________________________

Address _______________________________________________________________________________

Have you explained that the candidate's Cursillo experience will be paid for by others and does your candidate understand that he/she will then be asked to contribute toward future candidates' Cursillo?  [ ] Yes  [ ] No

Have you explained Grouping and Ultreya to your candidate? [ ] Yes [ ] No

Has your candidate participated in Grouping? [ ] Yes [ ] No

Is there a Group available to your candidate after the weekend? [ ] Yes [ ] No

Has your candidate attended an Ultreya? [ ] Yes [ ] No

Which Ultreya would you expect your candidate to attend? ______________________________________________

_________________________________________________________________________________________________

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Sponsor’s Signature __________________________________________ Date ___________________

 REV. 4/09 

      ALBANY EPISCOPAL CURSILLO APPLICATION

 Rector’s Name ___________________________________________________