24th NATIONAL CURSILLO ® ENCOUNTER
CHAPMAN UNIVERSITY
ORANGE, CALIFORNIA

July 31 - August 3, 2014 
Chapman University
Orange, 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 799
Jarrell, TX 76537
Phone: 512-746-2020
FAX: 512-746-2030 

 
  

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

 
Last Name: 
First Name: 
Address: 
City:   State:   Zip:  
Home Phone: 
Email: 
Diocese:      Region: 
 

Vocation (check one):  Bishop   Priest   Deacon   Vowed Religious   Laity

Leadership Role (check one):Spiritual Advisor   Assist. Spiritual Advisor   Lay Director
 Other: 

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?  If yes, name:
 
Need assistance - physically challenged? Describe need:
 

REGISTRATION FEES

The registration fee includes three nights lodging, dinner on Thursday evening, 3 meals on Friday and Saturday, and breakfast on Sunday morning. 
 
Chapman University is 25-30 minutes from John Wayne (SNA) and Long Beach (LGB) airports.  Shuttle service will be provided to/from both airports on Thursday, July 31, 2014.  Departure shuttles will be on Sunday, August 3, 2014.  Download campus map.
 
Cost is $335 per person if you register by May 31, 2014.
Registration fee increases to $385.00 per person beginning June 1, 2014.
Unable to guarantee registration after June 30, 2014.
 
Voucher # (if any):   
Discount (if any):   
 
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)
City:   State:   Zip:  

THIS IS A SECURE TRANSACTION.  We have taken every precaution to protect this transaction, using state-of-the-art 256-bit encryption software. 
 


CANCELLATIONS 

Please notify National Cursillo Center by email or fax for all cancellations.  There is a $40.00 non-refundable fee for all cancellations through May 31, 2014.  No refunds after May 31, 2014.  The National Cursillo Center is responsible for the payment to the University regardless of cancellations. 


National Cursillo® Center
P.O. Box 799
Jarrell, TX 76537
Phone: 512-746-2020,   FAX: 512-746-2030


 

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