RCIA Registration

Phone

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

First name

Last name

Email

Phone

Address

Gender

Male

Female

Birthday

Father's full name

Mother's full name

Mother's maiden name

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Email

Phone

Have you been Baptised?

Yes, I was baptized Catholic

Yes, I have been baptized in a Christian Church

No

Not sure

Please check additional Sacraments you have received in the Catholic Church:

Penance (Confession)

Eucharist (First Communion)

Confirmation

I am not Catholic.

What if any, is your present religious affiliation?

Marital Status

I have never been married.

I am engaged to be married.

I am legally married but I am not married in any Church.

I got married in a Church different from the Catholic Church.

I am married in the Catholic Church.

I am married, but separated.

I am divorced, and have not remarried.

I am divorced, and have remarried.

I am a widow/widower.

Please briefly explain.

Family Information Please list name, age and relationship of any children or dependent (son/daughter/stepchild/live in parent)

Family Member 1 Name, age, relationship

Family Member 2 Name. age, relationship

Family Member 3 Name, age, relationship

Family Member 4 Name, age, relationship

Family Member 5 Name, age, relationship

Who or what has led you to want to learn/know more about the Catholic Faith?

Please describe the types of religious education you have received, as a child and as an adult.

What contact have you had with the Catholic Church to date?

List if any, some of the questions or concerns you have about the Catholic Church.

Please choose one of the following statements that best describes your present feelings and thoughts about the possibility of joining the Catholic Church.

I am already Catholic.

I am just inquiring about the Catholic Church, not considering joining the Church yet.

I am considering joining the Catholic Church, but I am still unsure about it, still need to learn more about it and pray about it.

I am fairly sure that I would like to join the Catholic Church, but I still need some time to study and pray.

I am sure that I want to join the Catholic Church.

Place of Birth: City State Country

Thanks for submitting!