Please note: It is important to recognize that the Tres Dias experience is not for everyone. A
person suffering from mental or spiritual anguish, emotional duress, or personal crisis may do well to consider waiting to attend. The opinion of the Candidate’s Pastor or Priest is essential and may prevent serious complications during the Tres Dias weekend. The purpose of the weekend is to develop Christian service and should not be recognized as a form of crisis therapy.Please note: Except for the name and address, all information provided will be kept in strictest confidence.

This form must be completed and submitted before the candidate can be accepted for Tres Dias.

Candidates Name: (Last, First, Middle Initial)

Mailing Address:

City: State: Zip:

Parish or Congregation:

Attendance:
Select One Sporadic Fair Regular

Does this person have any physical needs that would require special attention?
Select One Yes No

If yes, describe:

Marital status, family status, comments?:

Are you aware of any physical, spiritual or emotional problems? Please specify.

Would you recommend this person for an intensive three-day encounter with Christ called the Tres Dias weekend?
Select One Yes No

Have you had other members attend a Tres Dias or similar weekends before?
Select One Yes No

How could this person best serve Christ and your congregation following this experience?

Any other helpful comments?:

Electronic Signature of Pastor or Priest:

Date: (MM/DD/YYYY)