Name
________________________________________
Nickname
________________________________________
Address
________________________________________
City, State, Zip
________________________________________
Home phone
________________________________________
Work Phone
________________________________________
Birth date
________________________________________
Marital status
________________________________________
Parish
________________________________________
Sponsor's name
________________________________________
Any Special needs?
________________________________________
________________________________________
Will your health and emotional condition sustain you through a rigorous weekend experience?
Yes NoHas your sponsor informed you about the Cursillo method and Fourth Day activities?
Yes NoSponsor's Endorsement
Name
________________________________________
Address
________________________________________
City, State, Zip
________________________________________
Home phone
________________________________________
Work Phone
________________________________________
Weekend/Diocese
________________________________________
Present parish
________________________________________
How long have you known the candidate?
________________________________________
Is your candidate ready and able to participate in a Cursillo weekend?
Yes No
Name
________________________________________
Parish
________________________________________
Home phone
________________________________________
Work Phone
________________________________________
Weekend/Diocese
________________________________________
How long have you known the candidate?
________________________________________
Is the candidate a member of your parish?
Yes NoA clergy agreement is an agreement with the sponsor's endorsement. It is also a pastoral opinion that the candidate is spiritually, physically, emotionally and psychologically able to meet the strenuous weekend schedule.
Do you recommend this person?
Yes No
________________________________________