RCIA
Inquiry Form

First Name

Last Name

Date of Birth

Phone Number

Email Address

Address

City

State

Zip Code

Are you an adult (18+) seeking Baptism?

Yes No

Are you a baptized adult (18+) seeking the sacrament of Confirmation?

Yes No

If "Yes" above, what was the date and place/church of the baptism, including its city and state?

What is your state in life?

Single, never married Single and divorced Married with no previous marriages Married with previous marriage(s)

Do you attend church at present?

Yes No

If "Yes" above, where? (name of church and city)

Please briefly describe what has brought you to this point in your spiritual journey:

First Name

Last Name

Email

RCIAInquiry Form