RCIA Inquirer Form

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Maiden Name (If Applicable) Please enter valid data.

Gender REQUIRED Please fill out this field.

Date of Birth REQUIRED Please fill out this field. Please enter a date.

Mailing Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

Occupation Please enter valid data.

Current Religious Affiliation Please enter valid data.

Have You Ever Been Baptized REQUIRED Please fill out this field.

In What denomination were you baptized? Please enter valid data.

Date of Baptism Please enter a date.

Church of Baptism Please enter valid data.

City Please enter valid data.

State

Zip Please enter a zip code.

If Baptized Catholic, which sacraments have you received? Confession Communion Confirmation

Current Marital Status REQUIRED Please fill out this field.

ENGAGED

ENGAGED (Fiancé's) Full Name Please enter valid data.

ENGAGED, Fiancés Religious Affiliation Please enter valid data.

ENGAGED--(ME) This is My First Marriage I have been Married Before

ENGAGED-- (Fiancé) Their First Marriage They have been married before

MARRIED

MARRIED-Spouse's Full Name Please enter valid data.

MARRIED-Spouse's Current Religious Affiliation Please enter valid data.

Date of Marriage Please enter a date.

Church of Marriage Please enter valid data.

City Please enter valid data.

State

Zip Please enter a zip code.

MARRIED--ME This is my first Marriage I have been Married before

MARRIED--Spouse His/Her First Marriage My spouse has been married before

List any Children or other Dependants

First Name Please enter valid data.

Last Name Please enter valid data.

Relationship Please enter valid data.

Age Please enter valid data.

First Name Please enter valid data.

Last Name Please enter valid data.

Relationship Please enter valid data.

Age Please enter valid data.

First Name Please enter valid data.

Last Name Please enter valid data.

Relationship Please enter valid data.

Age Please enter valid data.

First Name Please enter valid data.

Last Name Please enter valid data.

Relationship Please enter valid data.

Age Please enter valid data.

You will be contacted soon by R.C.I.A. directors Deacon Greg & Deb Marino.