Adult Sacrament Intake Form

Adult Sacrament Intake Form

Complete this form to register for OCIA or if you are an adult in need of sacramental preparation
Personal Information
Full Name*

First NameMiddle NameLast NameMaiden Name
Date of Birth*

MonthDayYear
Date
City / State of Birth*
Email*
example@example.com
Phone*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Sacramental Information
Have you been baptized before?*

YesNoUnsure
Denomination of Baptism
Catholic, Baptist, Non-denominational, etc.
Name & location of the church where you were baptized
Provide as much information as possible
Have you received your First Communion before (in the Catholic Church)?*

YesNoUnsure
Name & location of the church where you received First Communion
Provide as much information as possible
Have you been Confirmed (in the Catholic Church)?*

YesNoUnsure
Name & location of the church where you were Confirmed?
Provide as much information as possible
Marital Status (check all that apply)

SingleSeparatedEngagedWidowedMarried in the Catholic ChurchMarried in a non-Catholic churchMarried by a ministerMarried by a Justice of the PeaceDivorced and re-marriedDivorced and NOT re-marriedLiving with someone, but not married
If married, is this your first marriage?

YesNo
If married before, how many times?
Name of Current Spouse:
Religion of Current Spouse:
Should be Empty:

Sacramental Information