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Long Island Tres Dias Application to Serve on Team PERSONAL INFORMATION Print out this page and complete form Name___________________________________ Male Female Date of Birth_____/_____/_____ Street ___________________ City _______________________ State_____ Zip ___________ Home phone# ( )_________ Work # ( )___________ Fax: ( ) ___________ Email: _____________ Marital Status (circle one) Single / Widow / Div. / Married - Has your spouse made a Weekend? Yes No CHURCH & COMMUNITY INFORMATION Original Weekend # ______ Where?__________________________When?__________________________ Please indicate if other than Long Island Tres Dias ____________________ HOME CHURCH Name of Church ________________________________ Denomination ________________________ Address ___________________________________________________________________________ TRES DIAS EXPERIENCE # of Long Island Tres Dias Weekends you have worked (check one) ______0-1 ______2-4 ______5 or more Team Experience (check team assignments you have served in) ______Rector _____Asst. Rector _____Spiritual Advisor _____Chief Auxiliary ______Chief Kitchen _____Chief Musician _____Auxiliary _____ Kitchen Aux ______Table Leader ROLLO EXPERIENCE ______Ideals______Church______Piety ______Study______Action______Leaders ______Environments______CCIA______Reunion Groups ______Fourth Day Community Experience Do you participate in: (Place one of these Often "O" , Sometimes "S" , Rarely "R" , Never "N") Palanca _____ Secuelas _____ Agape Cleanup _______ Candle Chapel ______ Mananita _____ Agape Set-up _____ Closing _______ Tres Dias School YES______ No______ If accepted to serve on a team, do you: Have any physical restrictions that may prevent you from doing a certain task No____ Yes (explain)_________________________________________________________________ Have any special medical, physical, or dietary needs? No____ Yes (explain)________________________________________________________________ Fully understand the commitment of time, prayer and talents it will involve? No ____ Yes (explain) _______________________________________________________________ Total cost of the Weekend to the Community is $225. Any donations are greatly appreciated. Signature__________________________________________________ Date__________________
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