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R C I A
(Rite of Christian Initiation of Adults)
Registration Form

Please answer ALL questions with an asterisk (*)

*Full Name: *Phone Numbers:
*Address: Home:
  Work:
E-mail Address:
Date of Birth:    
City/State of Birth:
Father's Name:
Mother's Name:
*Baptismal Information: Are you baptized? Yes  No

If you are baptized, please answer all the following questions completely.
1. Date of Baptism:
2. Denomination:
3. Church of Baptism:
4. Place of Baptism (City/State):
*If you were baptized CATHOLIC, have you received the sacraments of:
Penance: Yes     No  Eucharist: Yes  No Confirmation: Yes  No
       
Marital Status:      
Single, never married    
Widow/widower, not remarried    
Divorced, not remarried    
Married (please also check the appropriate boxes below)  
  No previous marriages
  Previously married, previous spouse now deceased
  Previously married, previous spouse now living
 

Has your current spouse been previously married?

    No
    Yes – partner in previous marriage is now deceased
    Yes – partner in previous marriage is now living
       
Children living at home:
Name		 Age

Baptized

 Religion
Yes  No
Yes  No
Yes  No
Yes  No

How did you become interested in the Catholic Church:

We have child care available during our Monday evening sessions. Will you be needing this service?
 Yes  No
 

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March 07, 2007