19th NATIONAL CURSILLO® ENCOUNTER
SAN BERNARDINO, CA
July 30 - August 2, 2009 
California State University
San Bernardino, CA 
 
TO REGISTER (NOW) ON-LINE 
   Fill out this form from your browser 
   Use separate form for each registrant 
   Use MasterCard or VISA card as payment 
   Click on "Submit Form Now" button  		Submit completed form to:
National Cursillo® Center
P.O. Box 210226
Dallas, TX 75211-0226
Phone: 214-339-6321
FAX: 214-339-6322 

 
  

TO REGISTER (LATER) USING FAX OR MAIL 
   Use the printable registration forms --- do not use the form below 

 
Name:
(Last Name, First Name, Middle Initial)
Address: 
City:   State:   Zip:  
Country: 
Home Phone: 
Work Phone: 
Fax: 
Email: 
Diocese:      Region:  
 
Vocation (check one):  Bishop    Priest    Deacon    Religious    Laity
Gender (check one):  Male    Female
 
Preferred language:
 
If you desire to room with a specific individual (spouse, friend, etc.), both registration forms must be submitted within 2 hours of each other. 
 
Roommate preference? (check one): Yes     No    If yes, name:
 
Wheelchair/ physically challenged:
 
Do you wish to participate with the Encounter Choir? (check one): Yes     No
 
REGISTRATION FEES

The registration fee includes transportation to/from Ontario International Airport (ONT) only, three nights lodging, dinner on Thursday evening, 3 meals on Friday and Saturday, and breakfast on Sunday morning.  Registration includes ticket and transportation to the OMCC IV World Ultreya.
 
Cost is $360 per person if received by May 31, 2009.
Cost is $410 per person if received from June 1 to June 26, 2009.
Unable to guarantee lodging after June 26, 2009.
 
REGISTRATION FEE   $ 
 

PAYMENT OF FEES - SECURE SERVER 

Charge registration fee to my credit card (USA dollars): 
MasterCard  VISA 
 
Card Number:
Expiration Date:   
Cardholder's Name: 
(as appears on credit card)
Address:  
(from credit card billing address)
City:  
(from credit card billing address)
State: 
(from credit card billing address)
Zip/Postal Code: 
(from credit card billing address)
Country: 
(from credit card billing address)
 

THIS IS A SECURE TRANSACTION.  We have taken every precaution to protect this transaction, using state-of-the-art 128-bit encryption software. 
 

CANCELLATIONS 

Please notify National Cursillo Center by email or fax for all cancellations.  There is a $40 non-refundable fee for all cancellations before May 31.  No refunds after May 31, 2009.  The National Cursillo Center is responsible for the payment to the University regardless of cancellations. 

National Cursillo® Center
P.O. Box 210226
Dallas, TX 75211-0226
Phone: 214-339-6321,   FAX: 214-339-6322

 

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