| Sponsor's Name |
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| Street Address |
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| City |
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| State |
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| Zip |
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| Primary Phone |
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| Email |
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| Parish |
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| Candidate's Name |
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| Is the candidate a practicing Catholic? |
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| Is the candidate over 21 years old? |
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| What is the candidate's marital status? |
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| Is the candidate free from social, emotional, or mental problems (e.g. grieving a recent loss, recent divorce, recent job loss)? |
If not specify
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| How talkative/quiet, is your candidate? |
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| What common environment(s) do you share with your candidate? |
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| Have you explained the nature of the movement to your candidate (i.e., evangelization of environments, small group reunion, Ultreya)? |
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| If the candidate is married, have you explained the nature of the movement is to his or her spouse? |
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| Is there anything else about the candidate you think the Team should know before the weekend? |
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| Do you belong to a group reunion? |
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| Do you attend Ultreya? |
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| If yes, which Ultreya do you attend? |
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| If no, pleased indicate on of the following: |
Ultreya is...
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| Will you and/or co-sponsor "be there" after the weekend (to help your candidate to join a small group and attend Ultreya? |
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Catholic Diocese of Lexington Cursillo
