Oregon and SW Washington Episcopal Cursillo
Electronic version of "Oregon and SW Washington Episcopal Cursillo Database" form
Email address *
Contact Information
First Name *
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Last Name *
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Name on ID, if different
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Gender
Street Address
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City *
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State *
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Zip
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Cell Phone
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Other Phone
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Year of Birth
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If Ordained, Year of Ordination
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Home Parish/Church
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City/State of Home Parish/Church
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Year first attended Cursillo
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Diocese where first attended Cursillo
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Emergency Contact Name (and Relationship)
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Emergency Contact Phone
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