Canyon Creek Presbyterian Church

The total cost for the weekend will be $175 per person, which includes lodging and meals. You will not need additional money for the weekend. The registration fee of $50 should be sent with your application. You will be asked to pay the remaining $125 approximately 30 days before the weekend:

Registrar
Email: ntpcregistrar@sbcglobal.net

Scholarship Needs:
Please feel free to contact the Registrar at ntpcregistrar@sbcglobal.net for more information about this program.

Currently Scheduled Weekends:

2007
NTPC #22	Feb. 22-25 Lay Leader Jim Barlett	Pine Cove Christian Camp Tyler, Texas
NTPC #23	May 31-June 3 Lay Leader Jeanne Hooker	Lake Lavon Christian Camp Princeton, Texas
NTPC #24	Nov. 1-4 Lay Leader Becky Couch	Lake Lavon Christian Camp Princeton, Texas

Note: one applicant per form

Date of Cursillo Desired:

Today's Date:	Title:	Other Preferred Title:

Last Name:	First Name:	Preferred:

Address:
Street:		City/State/zip:

Home Phone:	Work Phone:	Mobile Phone:

Email Address:	Birthday:	Occupation:

Marital Status:	If Married, is spouse attending:

Emergency Contact for Cursillo Weekend:
Name of Emergency Contact:	Phone of Emergency Contact:

Presbyterian Church Membership:		Pastor:

Church Address:

Do you need a full or partial scholarship? (Registrar will contact you)
Do you smoke?
How did you hear about Cursillo?

If you have special requirements (allergy, diet, physical limitations, snoring) please explain:


Note: one applicant per form