CURSILLO TEAM ORIENTATION APPLICATION (Please Print)

Name:(Mr. Mrs. Ms.)

Name for Nametag:

Email:

Address:
City, State, Zip:
Home Phone No.:	Work Phone No.
Work E-Mail Address
Home Parish:	Parish City:

Attended Cursillo #	In Dallas/Fort Worth?	Yes	If not, what Diocese?
Would like to serve as the Music Leader on a Cursillo Team? (Guitar or Keyboard preferred)				Yes/No
Mail application and $5.00 check to: Episcopal Center for Renewal 10290 Monroe Drive, Suite 101 Dallas TX 75229		Date of Training: