Candidate Application

Please complete the Candidate Application form below.
After completing and submitting this form, please ask the Applicant’s pastor to complete and submit this short form.

Applicants can be added to a wait list by contacting our Pre Via de Cristo Rep: Holly Robillard at previadecristo@gmail.com

CANDIDATE INFORMATION

Please complete this information for the potential Candidate

Candidate First Name *

Candidate Last Name *

Gender *

Date of Birth *

Format: xx/xx/xxxx

Preferred Name *

By what name do you prefer to be called? Please type in your first name if you do not have a nickname that you prefer to use.

Candidate Weekend *

What Via de Cristo Weekend is the Candidate applying to attend?

Occupation *

Candidate Mobile Phone *

Candidate Work Phone

Candidate Home Phone

Candidate Email *

Candidate Street Address *

Candidate City *

Candidate State *

Candidate Zip Code *

Marital Status *

Number of Children *

Use the arrow button to the write to select a value

Present Church *

What is the full, official name of the church you attend?

Location of Church *

What city is your church in?

Pastor's Name *

What is the first and last name of your pastor?

Pastor's email address *

If you provide your pastor's email address, we will copy him/her on this application submission. Please let your pastor know that his/her recommendation is a prerequisite for your participation in a Via de Cristo Weekend and that he/she must go to https://goldcoastviadecristo.com/pastor-consent/ and sign the Pastor Consent form in order for you to attend the Weekend.

Have you been baptized *

Offices Held

Briefly list the offices or positions you have held in church or civic organizations. If none, please write "None"

Do you have any physical or medical restrictions?

Do you have any dietary restrictions? *

Do you have any special medical or physical dietary considerations?

Emergency Contact Name *

First

Last

Emergency Contact Mobile Phone *

Emergency Contact Home or Work Phone

I am aware that my pastor must sign the Acknowledgment Form *

SPONSOR INFORMATION

To be completed by the Sponsor

Sponsor First Name *

Sponsor Last Name *

Sponsor's Weekend *

I am currently in a Reunion Group *

Sponsor's Email *

Confirm Email

Sponsor's Mobile Phone *

Sponsor's Work Phone

Sponsor's Home Phone

Sponsor Street Address *

Sponsor City *

Sponsor State *

Sponsor Zip Code *

Sponsor's Present Church *

Denomination *

Number of years you have known the candidate *

Numeric values only. Minimum of one year to sponsor a candidate.

Why you recommend this Candidate *

Briefly explain why your candidate will benefit from and contribute to the VDC Movement.

Payment *

As the Sponsor, I will pay for the Weekend
I will explain to the Candidate about the cost of the Weekend
Someone else is paying for this Candidate

With God's help, I hereby commit to Sponsoring this Candidate *

Be prepared to (1) Personally escort your Candidate to Sendoff. (2) Be present during the Weekend for Chapel Palanca. (3) Personally escort the Candidate's wife to the Wive's meeting on Friday night. (4) Place the Candidate in a Reunion Group. (5) Followup on your Candidate's progress for at least one year. (6) Actively participate in your Candidate's Weekend.

Date *

Message

Pastor's Signature Required

Please click the button below to be taken to the Pastors' Signature Form.

PASTORS