Please complete the following information to ensure we have your most recent information. Please include all members of the household who are Cursillistas.

                    

  FULL Name first household member
 FULL Name second household member
                                                           MaleFemale MaleFemale
 Street Address
 
  City
 
  State
 
  Zip code
 
  Phone number 1
 Phone number 2
  E-mail Address 1
 E-mail address 2
  Parish 1
 Parish 2
  Cursillo made 1 if known
 Cursillo made 2 if known
 

Additional Cursillistas at this address

Full Name, E-mail address,

Cursillo made

  

Additional information or Comments

   
   

Updated 01/07/2009

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