Entertainment Application - On-Line

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Ministers of Music and Entertainment
Please provide all requested information.
When you have completed the form, click "Submit" and the information will be sent to the Cursillo Office. Thank You.
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- Name: REQUIRED Maximum 60 characters Please fill out this field. Please enter valid data.
- Address: REQUIRED Maximum 60 characters Please fill out this field. Please enter valid data.
- City: REQUIRED Maximum 60 characters Please fill out this field. Please enter valid data.
- State: REQUIRED Maximum 16 characters Please fill out this field. Please enter valid data.
- Zip: REQUIRED Maximum 10 characters Please fill out this field. Please enter valid data.
- Home Phone: REQUIRED Maximum 16 characters Please fill out this field. Please enter valid data.
- Work Phone: Maximum 16 characters Please enter valid data.
- E-Mail Address: REQUIRED Maximum 50 characters Please fill out this field. Please enter an email address.
- I Sing:
- I will Sing
- I play (instrument) (Organ/Keyboard) Maximum 30 characters Please enter valid data.
- I can lead/direct music for Mass
- I am an entertainer:
- Group Name Maximum 40 characters Please enter valid data.
- Brief description of skit : Maximum 50 characters Please enter valid data.
- I would be willing to be a Weekend Music Coordinator
- Select the following interests below: Maximum 1 characters Please enter valid data.
- Mass
- Comments/Preferences Maximum 90 characters Please enter valid data.
- Meditation:
- Comments/Preferences Maximum 90 characters Please enter valid data.
- Entertainment:
- Comments/Preferences Maximum 90 characters Please enter valid data.
Submit

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Peoria Cursillo Center

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Entertainment Application - On-Line