Pilgrim Application for Alabama Presbyterian Cursillo # 30

March 14-17, 2013

Name:_________________________________Prefer to be called: _______________

Address:_____________________________________________________________

Home Phone:_________________________Work Phone:______________________

Email:_________________________________Birthday(month/day):______________

Male _____ Female _____ Marital Status: __________________________________

Occupation: __________________________________________________________

Home Church:________________________________________________________

Pastor:______________________________________________________________

Sponsor's Name & Address:_____________________________________________

___________________________________________________________________

Food Allergies, Dietary Needs, Health Problems that require special attention:

___________________________________________________________________

Hobbies/Interests:______________________________________________________

Signature/Date:_______________________________________________________

Do you need financial assistance?______

To apply for a Cursillo weekend retreat,
print and fill out application and mail it to:
Sissy Crowe, Registrar
Alabama Presbyterian Cursillo
1256 E. Bellewood Dr.
Mobile, AL 36618
If you have any questions contact Sissy Crowe at:
Phone #:251-422-8406