Adult Inquiry Registration Form
Information on this form is held in confidence and is not shared without your permission.
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
Confirmation Email
example@example.com
Phone
*
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
Family Information
Father's Name
First Name
Last Name
Mother's MAIDEN Name
*
First Name
Maiden Name
Date of Birth
*
-
Month
-
Day
Year
Date
Place of Birth
*
Include town, city, county, state, and country
Religious History
What, if any, is your present religious affiliation?
*
Have you ever been baptized?
*
Yes
No
I am not sure.
In what denomination were you baptized?
Date or your approximate age when you were baptized?
Baptismal Name (if different from current name):
Place of Baptism
Name of Church and Denomination
Address, if known:
Location, if known:
Include city, county, state, and country
If you were baptized as a Catholic, check those sacraments you have already received:
Reconciliation (confession)
Eucharist (First Communion)
Confirmation
Current Marital Status
Check the appropriate statement.
I have never been married.
I am engaged to be married.
I am married.
I am married, but separated from my spouse.
I am divorced and I have not remarried.
I am a widow/widower and have not remarried since my spouse's death.
Your fiancee's name
First Name
Last Name
Your fiance(e)'s current religious affiliation:
For you:
This is my first marriage.
I have been married before.
For your fiance(e):
This is his/her first marriage.
My fiance(e) has been married before.
Your spouse's name
First Name
Last Name
Your spouse's current religious affiliation:
For you:
This is my first marriage.
I have been married before.
For your spouse:
This is his/her first marriage.
My spouse has been married before.
Date of Marriage
-
Month
-
Day
Year
Date
Place of Marriage
Include town, city, state, country
Officiating authority of marriage:
Civil government, non-Christian minister, Christian Minister, Catholic cleric
Family Information
List the name(s) of any children or other dependents (e.g. daughter, Jane; stephson-John)
Relationship
blanks
Name
Age
Type a label
Relationship
blanks
Name
Age
Type a label
Relationship
blanks
Name
Age
Type a label
Relationship
blanks
Name
Age
Type a label
Relationship
blanks
Name
Age
Type a label
Relationship
blanks
Name
Age
Type a label
General Questions
What or who has led you to want to 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?
*
What are some of the questions or concerns you have about the Catholic Church?
*
At this point in time, which of the following statements best describes your present feelings and thoughts about the possibility of joining the Catholic Church.
I need much more information about the Catholic Church before I would consider joining.
I am considering joining but I am still unsure about it.
I am fairly sure that I would like to join, but still need some time to study and pray about it.
I am fairly sure that I want to join the Catholic Church.
Registration Fee $30
*
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