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Christian Initiation (RCIA) Information Form
Welcome to St. Patrick Church RCIA (Rite of Christian Initiation) program.
The following information will help us serve you better. Once you complete this form a member of our RCIA team will contact you.
Full Legal Name:
*
First
Middle
Last
Address:
*
Street Address
City
State / Province / Region
Postal / Zip Code
Cell Phone #:
*
###
-
###
-
####
Email Address:
*
Confirm Email Address:
Date of Birth
*
MM
/
DD
/
YYYY
Age
*
Gender
*
Male
Female
City of Birth
*
State of Birth
*
Father's Full Name:
*
First
Middle
Last
Mother's Full Name:
*
First
Middle
Last
Mother's Maiden Name:
*
BAPTISM INFORMATION
Have you ever been baptized?
*
YES
NO
If 'YES' please provide the following information. If 'NO' skip to the Marital Status Section.
Date of Baptism:
Church Name:
City:
State:
Denomination:
If registering a child; was the child adopted?
Yes
No
MARITAL STATUS (ADULTS ONLY)
The Church considers marriage a sacred covenant and must formally review the circumstances of unions. If you or your spouse were previously married, divorced and/or married outside the Church, the Adult Formation Office will assist you in determing next steps.
What is your current marital status?
*
Single, never married
Engaged
Married
Separated
Divorced, not remarried
Divorced and remarried
Widowed
Please provide the following information if applicable.
Date of Marriage:
Church Name:
City:
State:
Denomination:
Have you been married more than once?
*
YES
NO
If 'YES', please provide the following information about any previous marriages:
Date of Marriage:
Church Name:
City:
State:
Denomination:
Use this box to provide the same information for any additional marriages:
If currently married or engaged, has your spouse/fiancée been married before?
YES
NO
If 'YES', please indicate how their marriage ended:
Divorce
Death
Separation
Annulment
If married or engaged, what is your spouse/fiancée's name?
First
Middle
Last
If married or engaged, what is your spouse/fiancée's faith tradition?
e.g. Catholic, Lutheran, Jewish, etc.
ADDITIONAL INFORMATION
If you have children, please list their names and ages:
What is the origin of your interest in the RCIA process?
I am sure I want to become Catholic
I am already Catholic and seeking Confirmaiton and/or Eucharist
I am undecided about becoming Catholic but want more information
What questions do you have about the Catholic faith?
Submission Date:
*
MM
/
DD
/
YYYY
