OCIA

Form
Date of initial contact and phone #.
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth

MonthDayYear
Date
Place of Birth
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Best time of contact
Previously Baptized?
If yes what denomination?
If you are baptized in another church please attach a copy of you baptismal certificate.
Upload File
If Under 18...
Father's Name

First NameLast Name
Religion
Mother's Name

First NameLast Name
Religion
School attending and the city
If 18+
Marital Status
Name of Fiancé/Spouse

First NameLast Name
Religion
Church of Marriage
Religion/Denomination
Date of Marriage

MonthDayYear
Date
For Office Use:
Date of meeting with Pastoral Minister

MonthDayYear
Date
OCIA formational path recommendation
Start Date

MonthDayYear
Date
Should be Empty:

Form