Candidate Application

[email protected]

NH Cursillo Application

Eligibility

Applicant must be at least 18 years of age
A baptized Catholic able to receive Holy Eucharist
This application MUST be received by NH Cursillo Committee two weeks prior to the scheduled weekend in order to ensure accommodations and plan for meals
If you have any questions, please contact the Pre-Cursillo Coordinator

Candidate Information

Which Cursillo would you like to attend?(*)

You must select a Cursillo weekend to continue

Name(*)

You must enter the applicant's name

Email Address(*)

Please enter a valid email address

Address 1(*)

Please enter a valid street address

Address 2

Please enter a valid street address

City(*)

Please enter a valid city

State(*)

Please select a state

Zip(*)

Please enter a valid zip code

Home Phone

Please enter a valid home phone number

Emergency Contact(*)

Please enter an emergency contact that will be available during the Cursillo weekend

Cell Phone(*)

Please enter a valid cell phone number

Emergency Contact Phone(*)

Please enter a phone number for your emergency contact

Parish Information

Are you able to receive the Sacrament of Holy Eucharist in the Catholic Church?(*)

Yes

Please select Yes or No

Are you affiliated with a Parish?

Yes

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If yes, which Parish?

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Marital Information

Marital Status(*)

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Spouse's Name

Please enter a valid name

Has your spouse lived a Cursillo?(*)

Yes

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Special Considerations

Cursillo events are alcohol free.
Smoking is allowed outside at designated smoking areas
All meals and snacks will be provided throughout the Cursillo weekend

Do you have any health conditions or special needs that could affect your participation during the Cursillo Weekend (e.g. Limited mobility/disability, Diabetic, Epileptic, allergies, etc.)?(*)

Yes

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If yes, please specify:

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Do you need to be attentive to food content due to allergies or dietary restrictions?(*)

Yes

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If yes, please specify:

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Privacy Authorizations

From time to time, NH Cursillo publishes photos, names, parishes, and/or city/state of people who live a Cursillo weekend to welcome and introduce them to the Cursillo community. However, we want to respect your privacy. Therefore, NH Cursillo would like your permission to publish the following information as needed:

I grant NH Cursillo permission to use my NAME in the NH Cursillo website, newsletters, and/or other publications.(*)

Yes

Please select Yes or No

I grant NH Cursillo permission to publish my PHOTO on the NH Cursillo website, newsletters, and/or other publications.(*)

Yes

You must select Yes or No

I grant NH Cursillo permission to publish my PARISH on the NH Cursillo website, newsletters, and/or other publications.(*)

Yes

You must select Yes or No

I grant NH Cursillo permission to publish my CITY and/or STATE on the NH Cursillo website, newsletters, and/or other publications.(*)

Yes

You must select Yes or No

Donation Information

The customary donation for the weekend is $250.
A minimum deposit of $125.00 should be submitted with each Application. Any remaining balance is due upon check-in on Thursday evening of the Cursillo weekend.
Cash is accepted during check-in, but checks are preferred.
If a donation at this level is not possible, please contact the Pre-Cursillo Coordinator to discuss scholarship funding.

Please send your donation check made payable to NH Cursillo Committee to:

NH Cursillo Committee
133 Wayne St.
Manchester, NH 03102

By typing my name, I am electronically signing this application(*)

You must enter a valid signature to continue

Date(*)

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