RCIA intake form
Please complete this form and Deacon Richard will respond as soon as possible.
Full legal name
*
Nickname
Date of birth
*
City and state of birth
*
Have you been baptized? If so, in which denomination?
*
Street address
*
E-mail
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Are you or have you ever been married?
*
Please Select
Yes
No
If married, spouse's first name
Have you ever been divorced?
*
Please Select
Yes
No
If you have been divorced, have you had an annulment?
Please Select
Yes
No
Mother's name (with maiden name) and denomination
Father's name and denomination
Occupation/employer
Briefly state what is drawing you to the Catholic faith
Do you have a sponsor in mind? If so, who?
Questions/comments?
Submit Form
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