APPLICATION FOR LOUISIANA PRESBYTERIAN CURSILLO
(Separate applications if spouses are attending together)
Date Cursillo desired
Last name:
Spouses name:
First name
or Nick name
Address
City, State, Zip
Home Phone:
Work Phone:
 Spouses Phone:
E-mail Address
Mobile Phone:
Occupation
Spouses Occupation
Birthday
Spouses Birthday
Marital Status
If married is Spouse attending?
Are you a member of a Presbyterian Church?  If yes, which church.
How did you hear about Cursillo?
Pastor
Pastor Address
Sponsor's Name
(optional)
Sponsor's Address
(note:  A sponsor will be provided for you if you do not already have one)
If you have any special requirement (allergy,
diet, physical limitation, snoring) please explain:
Hobbies/interests
Cursillo is a grace-filled and fully occupied three days.  It is not designed to address emotional problems.
If you have any questions concerning the advisability of your attending at this time, please contact the
Registrar, your pastor or your sponsor.

Cost:  The total cost of $210.00 for the weekend includes lodging and meals.  You will not need additional
money.  The registration fee of $50.00 should be sent with the application.  You will be asked to pay the
remaining balance approximately 30 days before the weekend.  Please make checks payable to: Faith
Presbyterian Church, (put LPC1 in notation line on check.)

Scholarship Needs:  Please feel free to contact the registrar Jani Gage:  JGage.LPC@gmail.com for more
information.

Schedule, Location and Cost (per person):

Applications: A limited number of spaces are available.  Applications are processed in the order they are
received.  Please return your application and registration fee as soon as possible to:

Jani Gage, Registrar
Faith Presbyterian Church
12855, Old Hammond Highway, Baton Rouge 70816
Phone 225/275-7393, email:  JGage.LPC@gmail.com
September 25-28, 2008
$210 per person
Wesley Center, Woodworth, LA
(for more information regarding the
location go to
www.thewesleycenter.com)