OCIA Intake Form
Order of Christian Initiation of Adults
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact Number
*
E-mail
*
example@example.com
Date of Birth
*
Place of Birth
*
Have you been baptized?
*
Yes
No
If you have been baptized, where were you baptized?
Name of Church:
Address of Church:
Denomination of Church:
Date of Baptism?
Father's name?
*
Father's religion?
*
Mother's name (include Maiden name)?
*
Mother's religion?
*
Are you currently married?
*
Yes
No
If you are NOT currently married, have you EVER been married to another person in church, civilly, or in common law?
*
Yes
No
Not Applicable because I am currently married.
If you ARE married, what is the name of your Spouse?
Religion of Spouse:
If you ARE currently married, what was the date and place of marriage?
What is the name of the officiant who married you?
If married in a non-Catholic Church did the Catholic receive a dispensation?
*
Yes
No
Not Applicable
Prior to this marriage, have YOU ever been married to another person in church, civilly, or in common law?
*
Yes
No
Prior to this marriage, has your spouse ever been married to another person in church, civilly, or in common law?
*
Yes
No
Today's Date?
*
-
Month
-
Day
Year
Date
By typing your name here you are agreeing to share this information and proclaiming its truthfulness.
First Name
Last Name
Submit
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