ARCHDIOCESE OF ST LOUIS-OCIA FORM
Parish Name
Today's Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Name:
First Name
Middle Initial
Last Name
Maiden Name (if applicable):
Male or Female:
Date of birth:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Place of birth: City:
State:
Father's Name:
First Name
Middle Initial
Last Name
Mother's Name:
First Name
Middle Initial
Last Name
Suffix
CONTACT INFORMATION
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone:
Format: (000) 000-0000.
Email:
example@example.com
Parishioner:
Yes
No
Parish Name and City:
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RELIGIOUS HISTORY
Have you ever been baptized?
Yes
No
If you answered "yes" please provide the following Information
(a) In what denomination were you baptized?
(b) Date or your approximate age when you were baptized:
(c) Baptismal name (if different from current name):
(d) Place of Baptism (name of church/denomination):
(e) Address, if known:
(f) If you were baptized in a Catholic Church, what sacraments have you already received?
Reconciliation/Penance
Eucharist (First Communion)
Confirmation
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MARITAL STATUS
Marital Status Options
Never Married
Engaged
Married
Married, but separated
Divorced, not remarried
Widowed, not remarried
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IF ENGAGED
Is this your first marriage?
Yes
No
If no: Annulment started?
Yes
No
Annulment granted?
Yes
No
Is this your fiancé's first marriage?
Yes
No
If no: Annulment started? (Fiancé)
Yes
No
Annulment granted? (Fiancé)
Yes
No
Fiancé's Name
First Name
Middle Initial
Last Name
Fiancé's current religious affiliation (if any):
IF MARRIED
Spouse's Last Name
First Name
Middle Initial
Last Name
Maiden Name (if applicable):
Religion:
Date of Marriage:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Place of marriage:
Officiant:
Civil
Christian Minister
Non-Christian minister
Catholic minister
Denomination (If Non-Catholic minister):
Location of ceremony:
Is this your first marriage? (Married section)
Yes
No
If no, is previous spouse alive?
Yes
No
If no: Annulment started? (Married section)
Yes
No
Annulment granted? (Married section)
Yes
No
Has your spouse had a previous marriage?
Yes
No
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Do you have any dependents or children?
Yes
No
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FAMILY INFORMATION
List the name(s) of any children or other dependents (e.g., Daughter – Jane, Stepson-John)
Dependent 1 Relationship
Dependent 1 Name
First Name
Last Name
Dependent 1 Age
Dependent 2 Relationship
Dependent 2 Name
First Name
Last Name
Dependent 2 Age
Dependent 3 Relationship
Dependent 3 Name
First Name
Last Name
Dependent 3 Age
Dependent 4 Relationship
Dependent 4 Name
First Name
Last Name
Dependent 4 Age
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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 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? Please select one.
I need much information about the Catholic Church before I would consider joining.
I am considering joining, but I am still not sure at this time
I am fairly sure that I would like to join, but I still need some time to study and pray about it.
I am fairly sure that I want to join the Catholic Church.
OCIA PARTICIPANT INFORMATION FOR SACRAMENTAL REGISTER
1.
First Name
Last Name
2.
First Name
Last Name
Confirmation Name
First Name
Last Name
Sponsor
First Name
Last Name
Sacrament Received
Baptism
Profession of Faith
Additional Sacraments Received
Eucharist
Confirmation
OCIA Participant
Yes
No
Signature
OFFICE USE ONLY
Date received sacraments
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Minister of Sacraments
First Name
Last Name
Minister Signature
Registers recorded date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Registers recorded by
First Name
Last Name
PHOL recorded date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
PHOL recorded by
First Name
Last Name
Servant Keeper recorded date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Servant Keeper recorded by
First Name
Last Name
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