Cursillo Candidate Application
Please fill out the form in its entirety.
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Email *
Name *
First and last name
Email *
Please provide the address where you want all Cursillo emails to go.
Address *
(Street address, City, ZIP)
Phone number *
Please provide the number you prefer us to contact you
Birthday *
MM
/
DD
Occupation
Emergency Contact *
 Please provide Name, phone #, relationship to this person)
Marital Status *
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