Rite of Christian Initiation for Adults

First Name REQUIRED Please fill out this field. Please enter valid data.

Middle Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Date of Birth REQUIRED Please fill out this field. Please enter a date.

City & State of Birth REQUIRED Please fill out this field. Please enter valid data.

Age REQUIRED Please fill out this field. Please enter an integer (number).

Father's Full Legal Name REQUIRED Please fill out this field. Please enter valid data.

Mother's Maiden Name REQUIRED Please fill out this field. Please enter valid data.

Mother's Full Legal Name REQUIRED Please fill out this field. Please enter valid data.

Mailing Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Cell Phone Number Please enter a phone number.

May we send you texts? Yes No

Email REQUIRED Please fill out this field. Please enter an email address.

What, if any, religious tradition do you presently practice? REQUIRED Please fill out this field. Please enter valid data.

Have you been baptized? REQUIRED Unsure No Yes Please fill out this field.

If yes, what is the date of your baptism? Please enter valid data.

If yes, what is the name and location of the church where you were baptized? Please enter valid data.

If yes, who was the minister? Please enter valid data.

If you were baptized Catholic, what other sacraments have you received? Eucharist Reconciliation Confirmation

What is your marital status? REQUIRED I have never been married. I am engaged. (Kristina will contact you for more info.) I am married. (Kristina will contact you for more info.) I am married, but separated from my souse. I am divorced, and I have not remarried. I am a widow(er) and have not remarried since my spouse's death. Please fill out this field.

Do you have a spouse or children interested in becoming Catholic? Please list their name, relationship and age. Please enter valid data.

If you have been regularly attending mass, when and where do you usually go? REQUIRED Please fill out this field. Please enter valid data.

Do you know anyone who attends mass at St. John Paul II? If so, who? REQUIRED Please fill out this field. Please enter valid data.

Who or what has led you to learn more about the Catholic faith? REQUIRED Please fill out this field. Please enter valid data.

Please describe your contact with the Catholic Church before inquiring about RCIA. Please enter valid data.

Please describe your past religious education in any faith tradition that you received as a child or adult. REQUIRED Please fill out this field. Please enter valid data.

What questions or concerns do you have about the Catholic Church or the process to become Catholic? Do you have any specific topics or interest or burning questions about Catholic beliefs and practices? Please enter valid data.

Please share a little bit about yourself, such as your family, hobbies, or fun facts. Please enter valid data.

Rite of Christian Initiation for Adults

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