| Application Form to be a Guest at a Cursillo Weekend (Coventry Diocesan Cursillo) |
Coventry Diocesan Anglican Cursillo – Weekend Application Form.
; (You may prefer to return a photocopy of this form in order to retain the information)
PLEASE USE BLOCK CAPITAL
The Cursillo Weekend you are applying for No........................ ..Date..........................................
Surname............................. I............................................................ Title.................
Christian name.................................................................................... Wish to known as ........................ .
Address................................................................................................................................................................
...........................................................................................................................................................................
..........................................................................................................................Post Code...............................
.
Telephone..............................................................Email..................................................................................
.................................................................................
Church where you worship .................................................................................
Are you confirmed?.............age group on arrival date (minimum age 18) 18-21/22-35/36-45/46-55/56-65/66+
(please circle age)
Have you any special needs? (diet, disability, allergy etc.)...................................................................................
If you are coming on your own, you may be asked to share a room. Since there are only a limited number of single
rooms available, it would be helpful if you could delete/circle/fill in as relevant. -:
- I am happy to share a room / I plan to share with ...................................../I prefer a room to myself
Your details will be passed on to those organising the weekend, and for entry into the Coventry Cursillo address
book. If you would prefer not to have an entry in the address book please tick this box □
Cost.
Coventry Cursillo is largely faith funded for applicants from the Coventry Diocese. We ask only for a non-
returnable deposit of £40 to be sent with this form. Cheques to be made payable to COVENTRY DIOCESAN
CURSILLO. (The actual cost of a Cursillo weekend is £132 (2008)).
Signature of applicant.......................................................................... Date......
Please ask your PARISH PRIEST 'to endorse this application so that he/she is aware of your intentions.
Name.............................................................................................................
Signature.........................................................................................
Address
............................................................................................................................................................................
..................................
......................................................................................................................................................................
Post Code……………………………………
Telephone………………………………………………………
Put here the name of the person who told you about Cursillo......................................................
If you have any questions about Cursillo please do not hesitate to contact Send yourcompleted form
The Below To The Below
; (You may prefer to return a photocopy of this form in order to retain the information)
PLEASE USE BLOCK CAPITAL
The Cursillo Weekend you are applying for No........................ ..Date..........................................
Surname............................. I............................................................ Title.................
Christian name.................................................................................... Wish to known as ........................ .
Address................................................................................................................................................................
...........................................................................................................................................................................
..........................................................................................................................Post Code...............................
.
Telephone..............................................................Email..................................................................................
.................................................................................
Church where you worship .................................................................................
Are you confirmed?.............age group on arrival date (minimum age 18) 18-21/22-35/36-45/46-55/56-65/66+
(please circle age)
Have you any special needs? (diet, disability, allergy etc.)...................................................................................
If you are coming on your own, you may be asked to share a room. Since there are only a limited number of single
rooms available, it would be helpful if you could delete/circle/fill in as relevant. -:
- I am happy to share a room / I plan to share with ...................................../I prefer a room to myself
Your details will be passed on to those organising the weekend, and for entry into the Coventry Cursillo address
book. If you would prefer not to have an entry in the address book please tick this box □
Cost.
Coventry Cursillo is largely faith funded for applicants from the Coventry Diocese. We ask only for a non-
returnable deposit of £40 to be sent with this form. Cheques to be made payable to COVENTRY DIOCESAN
CURSILLO. (The actual cost of a Cursillo weekend is £132 (2008)).
Signature of applicant.......................................................................... Date......
Please ask your PARISH PRIEST 'to endorse this application so that he/she is aware of your intentions.
Name.............................................................................................................
Signature.........................................................................................
Address
............................................................................................................................................................................
..................................
......................................................................................................................................................................
Post Code……………………………………
Telephone………………………………………………………
Put here the name of the person who told you about Cursillo......................................................
If you have any questions about Cursillo please do not hesitate to contact Send yourcompleted form
The Below To The Below
Spiritual Director and/or Lay Director Bookings Co-ordinator
Revd Keith Mobberley Mrs. Jackie Cubitt Mrs. Maggie Seldon
North Ferncumbe Rectory 18 Erithway Road 11 Frankpledge Road
Hatton Green Lane Cheylesmore
Warwick Coventry Coventry
CV35 7EX CV3 6JT CV3 5GT
01926 484332 024 76 692720 024 76 503367
Revd Keith Mobberley Mrs. Jackie Cubitt Mrs. Maggie Seldon
North Ferncumbe Rectory 18 Erithway Road 11 Frankpledge Road
Hatton Green Lane Cheylesmore
Warwick Coventry Coventry
CV35 7EX CV3 6JT CV3 5GT
01926 484332 024 76 692720 024 76 503367
| Print out form using the PDF format below (preferred option) |
