401 N.E. Madison Ave. Peoria, IL 61603
(309)676-5587

Entertainment Application

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 Please fill out this field. Please enter valid data.
- Address: REQUIRED Please fill out this field. Please enter valid data.
- City: REQUIRED Please fill out this field. Please enter valid data.
- State: REQUIRED Please fill out this field. Please enter valid data.
- Zip: REQUIRED Please fill out this field. Please enter valid data.
- Home Phone: REQUIRED Please fill out this field. Please enter valid data.
- Work Phone: Please enter valid data.
- E-Mail Address: REQUIRED Please fill out this field. Please enter an email address.
- I Sing:
- I will Sing
- I play (instrument) (Organ/Keyboard) Please enter valid data.
- I can lead/direct music for Mass
- I am an entertainer:
- Group Name Please enter valid data.
- Brief description of skit : Please enter valid data.
- I would be willing to be a Weekend Music Coordinator
- Select the following interests below: Please enter valid data.
- Mass
- Comments/Preferences Please enter valid data.
- Meditation:
- Comments/Preferences Please enter valid data.
- Entertainment:
- Comments/Preferences Please enter valid data.
Submit

Peoria Cursillo Center