"Experience serving on a team"

Please take a moment to help us better serve our community and upcoming Cursillo teams.  If you are new to our community and have not filled out the Registration Page, please do that first, then come back and complete this survey. Thank you for being a part of our leadership community.  

First Name   (name preferred to be called)

Last Name    

Address        

City              

State            

Zip Code       

Phone # - Home    
Phone # - Work     
Phone # - Cell     

Sex      Male  Female

Occupation   

Email           

Parish          

Cursillo History:

Date made Cursillo:       
Location made Cursillo:  

Number of Cursillos you've served on:   
Date last served on a team?    In what capacity?   

Check the box indicating the Core team positions you've served on:
    Music Chair
    Liturgy Coordinator
    Rector (a)
    Assistant Rector (a)
    Advisor
    Service Team Chair
    Assistant Service Team Chair
    Referred by  previous Rector (a) as possible candidate for future Rector(a).  
Referred by:   

Indicate the number of times have you served in these positions, including assistant:
Service Team                  
Music                              
Rollo (how many)             
Table Leader                   
Palanca coordinator          
Sponsor coordinator         

List other positions served

Do you play a musical instrument?   yes  no 
What instrument  do you play?   


Please list other talents  


Do you have any specific dietary or medical requirements regarding the duties of a team member?

 Cursillo Community Data:

Are you currently active in a 4th day  group?   yes  no
Is the 4th day group?  Men's Women's Co-ed
When and where do you meet?   (host?)

Have you participated in School of Leaders? yes  no    
Date last attended School of Leaders                         

Are you open to serving on a committee?                   
Are you open to serving as a Parish Representative?