MARYLAND EPISCOPAL CURSILLO WEEKEND APPLICATION

Title: Miss Ms. Mrs. Mr. Dr. The Rev. (Circle one)

Name: _____________________________ Telephone (H) _____________ (O) ___________
Address:____________________________________________________________________
Name to be used on Button: ________________________ Date of Birth: __________________
Occupation: ________________ Marital Status: ______ Spouse’s Name: __________________
Children (Names/Ages):_________________________________________________________
Home Parish:_______________________________________________________________
                                                                                (Name, Location, Denomination)

Week-End you wish to attend:____________________________________________________
Please describe what your sponsor has shared with you about the Fourth Day?
___________________________________________________________________________
___________________________________________________________________________
Please identify any dietary, physical or medical restrictions/concerns: _______________________
___________________________________________________________________________
Emergency Point of Contact: __________________________ Telephone: __________________
                                                   (Name & Relationship)
+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
On the back of this application please write a brief, frank statement addressing why you wish to attend a Maryland Episcopal Cursillo weekend.
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Sponsor Endorsement: I (we) acknowledge my (our) responsibilities to provide transportation to and from the Cursillo weekend and Reunion Ultreya; to encourage the continued involvement with regional Ultreya(s); to provide assistance in getting established in a Permanent Group Reunion; and to support the candidate throughout their Fourth Day in their walk with Christ.

Signature(s):_________________________________________________________________
Name(s): __________________________________ Telephone: (H) ____________________
Address: ________________________________________     (O) ____________________
Date/Location of your Cursillo: ____________ Fourth Day Workshop: ___________________
+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
Clergy Endorsement: I know the above named person and am aware that he/she is applying to attend a Cursillo weekend. I am not aware of any problem or reason that should preclude such candidate’s attendance and, therefore, I endorse this application.
Signature:___________________________________________________________________
Name: __________________________________ Telephone (H):_______________________
Parish: __________________________________ Position:_____________________________
CursilloApplication(8-98)

Send Cursillo Weekend applications to the Assistant Lay Director (click the link to get contact information).

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