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Application |
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Name:
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Age: |
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Address:
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Phone: ( ) |
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City:
State:
Zip:
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Cell Phone: ( ) |
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Date of Birth:
Place:
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Are you a US
citizen?
Are you a US
resident? If
yes, do you have a green card?
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Email:
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Height:
Weight:
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Education (Circle One):
High School - College - Other ___________
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Are you a practicing Catholic, having received
Baptism, First Communion and Confirmation?
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Any debts or financial obligations?
If yes, explain.
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Have you been a member of a Seminary or Religious Order? If yes, please explain.
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Do you spend time in prayer & spiritual
reading: ____Daily? ____Sometimes?
____Weekly?
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Do you presently live a celibate lifestyle?: If
yes; for how long? _________
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Do you attend Mass:
____Daily? ____Sometimes? ____Every Sunday?
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Do you live with: ___ parents? ___ or
relative? ___ apartment/rented room? ___ own home?
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Emergency Contact Name & Phone Number:
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Do you have any physical impairments or chronic
illnesses?
Do you smoke?
_______
For how long?_______
Do you consume alcohol?
_______
How much?_________
How is your
health?
Explain:
Have you ever used illicit
drugs?
Explain:
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Do you take regularly any prescribed medicine?
Please list medicines & reason for prescription:
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Are you presently or have been under the care of a psychologist?
For what reason?
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Do you require a special diet?
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Please attach a recent photo of yourself .
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How long have you been thinking about the
contemplative life? What attracts you to seek this way of life?
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Weekend Applying For:
1st Choice: ______________ 2nd Choice:
______________
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Please mail application to: Mt. Carmel Hermitage,
P.O. Box 337, Christoval, Texas 76935-0337
Or email to: [email protected]
Phone: 325-896-2249
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