OCIC Interest Form
Child's Full Name
First Name
Middle Name(s)
Last Name
Preferred Name or Nickname (if applicable)
Child's Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
City/State of Child's Birth
Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Father's Name
First Name
Last Name
Father's Email
example@example.com
Father's Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Mother's Name (Please include Maiden Name)
First Name
Maiden Name
Last Name
Mother's Email
example@example.com
Mother's Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Who Should We Contact?
Mother
Father
Both
Other
Are your family registered parishioners at St. James the Apostle?
Yes
No
Not Sure
Other
What Sacraments are you seeking for your child?
Is there anything else we should know?
Submit
Should be Empty: