Congregation of Jesus and Mary

North American Province

Philippine Community
Application Form
Instruction: Please answer this questionnaire with greatest sincerity and return this to the priest in-charge of Formation for the Eudist Fathers together with
the following:
A new baptismal and confirmation certificate
An official document relative to the academic file
A recent medical report
Two recent passport photos

Personal Information
Last name First name Middle name
Birth date Contact Number Current Parish
Day / Month / Year Email Address Current Diocese
Provincial Current
Address Address
No. & Street Town/ City Province Country No. & Street Town/ City Province Country

Family Background
Father Mother

First Name Last Name First Name Last Name

Occupation Occupation
Date of Marriage Place of Marriage
Date of civil divorce (if applicable) Date of annulment (if applicable)

Brother Sister
Name Birth date Name Birth date

Family Member(s) who are(is) Religious or Priest(s)

Name Religious Order / Diocese

Educational Background
Name of School Year Graduated
Elementary
High School
College
School Major Degree Year Completed
 Name of School Number of units or years
Philosophy
Theology

Work Experience
Name of Company / Institution Years Spent Designated Position

Physical and Mental Health

General Health
Do you consider yourself in good health at this time? Yes No
Have you always been in good health? Yes No
Have you ever had to stop your studies because of bad health? Yes No How many times? How Long?
What serious illnesses you have suffered from in the past?
Do you have any chronic conditions that require medical attention? Yes No If yes,
please specify
Have you had a problem with alcohol or substance abuse? Yes No

Physical Health
Do you have any physical handicaps? Yes No If yes, please specify
Have you ever had any surgery? If yes,
Yes No When
please specify
Do you have good eyesight? Yes No
Is your hearing good? Yes No

Family Health History

Specify
Do you know of anyone among your parents or Yes No
relatives who has suffered from depression or other
mental diseases?
Are you aware of any hereditary disease in previous Yes No
generations?
Is there any history of alcoholic or drug abuse in your Yes No
family?
Anyone hospitalized for a psychiatric disease? Yes No

Affiliation
Name of Organization Position Date Aptitude or Gift Used
Financial Situation
What is your source of income right now? Can you live decently with this income?
List of Debts
Amount To whom Repayment plan / pay off date

Personal History
Civil Marriage Religious Marriage
Date of Marriage
Place of Marriage
Date of Divorse/ Annulment / Death of Spouse

Previous Community
Name of Diocese or Congregation Number of years Vows or Commitment Reason of leaving

Previous Formators
Name Diocese / Congregation E-mail Address Contact Number

References (List the persons who could give an opinion regarding your application)
Name Address E-mail Address Contact Number

Write an Essay answering the following and submit it with this application form.
(1) Describe as clearly as possible what has brought you to this point of considering making a request
for admission as a candidate for the Eudist Fathers.

(2) Answer in your own words the following two questions:

What does it mean to you to be a priest and to be a Eudist priest?
How do you see the ministry and the life of the Eudist priest today?

I hereby attest that I have filled out this application completely and I have not withheld any information about my past
that would be relevant to my acceptance. If I have concealed any information, I understand that this may negatively affect my
acceptance or continuation in the formation program of the Eudist Fathers.

Signature: _________________________________________
Date: ____________________________________