Candidate Application for Cursillo

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This online form is for those interested in attending a Cursillo weekend. If you have any questions, please contact Grace Wiemann at 859-351-5995 or wiefam@icloud.com. If you prefer, you may download an offline application here and mail it in.

To reserve your room, we need to receive a $50 deposit. You may either pay online or by mailing a check. Instructions can be found below. The $50 deposit is applied to the total cost of your room. The cost of the weekend is $170 for double occupancy and $300 for single occupancy.

We realize that for some the total cost of the weekend might be prohibitive. Therefore, limited scholarships are available as our budget allows. Contact Grace Wiemann at 859-351-5995 or wiefam@icloud.com for information regarding available scholarships.

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Name: *

First

Last

Date of Birth: *

Mailing Address (street, city, state, zip): *

Email Address: *

Phone Number: *

Numbers only

Parish: *

How many years have you been a confirmed Catholic? *

Can be approximate

Sponsor's Name (if you have one):

Are you married?

• Yes
• No

If married, please enter spouse's name:

If married, is your spouse Catholic?

• Yes
• No

If married, has your spouse attended a Cursillo weekend?

• Yes
• No

Please list any Parish ministries or other church-related activities with which you are currently involved:

Please list any food allergies or other special dietary needs:

On Fridays, do you abstain from meat?

• Yes
• No

If you have any special physical or medical needs, please specify:

Weekend Selection: *

• Women’s Weekend (January 16-19, 2025)
• Men’s Weekend (February 27 - March 2, 2025)

Room Selection: *

• Double Occupancy ($170)
• Single Occupancy ($300)
• Student Rate ($150)

For Double Occupancy, do you have a preferred roommate? If so, please specify:

Submit