Cursillo Database Information

Name

Nickname

Address

City

State

Zip

Phone

Cell Phone

Email address

Age

Date of Birth

-- mm/dd/yy

Church Currently Attending

Attended Cursillo Weekend #

Year of Weekend

Location

Are you currently Grouping?

Yes No

If yes, please list Day, Location & Time

Who do you Group with?

Have you ever participated as a team member on a Cursillo Weekend?

Yes No

What position(s) have you held?

What Rollo(s) have you given?

Occupation?

Special Talents?

Would you like to be included on our Prayer Chain email list?

Yes No

Would you be willing to assist the Community on special projects?

Yes No

Would it be OK to email you the Newsletter?

Yes No

Would you be willing to be your Parish Representative for Cursillo?

Yes No

Would you be interested in working a team?

2006?
2007?
Sometime?

Would you be interested in attending a Day of Deeper Understanding?

Spring 2006?
Fall 2006?

Do you have children who have attended Happening?

Yes No

If yes, Name and Year attended

How would you like to see the Cursillo Community Change or grow in the coming year(s)?

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