Adult Faith Formation & Sacraments Program

RCIA, Adult Confirmation, Adult First Communion, and Ongoing Adult Faith Formation

Registration is for adults (18 years old and older) in need of the sacraments of initiation (i.e. baptism, confirmation and/or first communion), ongoing faith formation, or who would like to become Catholic.

Contact Information

Registered in this parish?
Required*

	Yes
	No

Full Name

Title

First Name*

Middle Name

Last Name*

This is how your name will be registered in our sacramental records and your certificates.

Address

Street 1*

Street 2

City*

State*

Zip*

Father's Name

Required*

This is required for our sacramental records.

Mother's Name (Maiden)

Required*

Please include her maiden name.

If the Faith Formation material will be mailed to a different address, please enter it here

Street 1

Street 2

City

State

Zip

Primary Phone

Required* --

Secondary Phone

--

Email

Required*

Emergency Contact Name

First Name*

Last Name*

Emergency Contact Relationship

Required*

Emergency Phone Number

Required* --

Birth Certificate Information

The following information should be the same as what is on your birth certificate.

Full Name on Birth Certificate

First Name*

Middle Name

Last Name*

Sex
Required*

	Male
	Female

Birth Date

Required* //

Place of Birth

Required*

City and State

Country

Required*

Sacraments Received

Please complete this part of the form if you have received any of the following sacraments.

Sacraments Completed
Required*

	None
	Baptism
	Confession
	First Communion
	Confirmation
	Marriage

Date of Baptism

//

Baptised in the Catholic Church?
Required*

	Yes
	No

What Denomination if not Catholic?

If not baptized in the Catholic Church, please let us know which denomination, e.g. Baptist, Methodist, Lutheran, etc.

Place of Baptism

Name of Church, City, State & Country

Date of First Communion

//

Place of First Communion

Name of Church, City, State & Country

Date of Confirmation

//

Place of Confirmation

Name of Church, City, State & Country

Are you in a civil marriage?
Required*

	Yes
	No

Are you married in the Church?
Required*

	Yes
	No

Any previous marriages?

Required*

Questions, Comments & Concerns

	Please feel free to write any questions, comments or concerns you may have about the RCIA.
Questions		Please let us know if you have any questions about this program.
Comments		Please let us know if you have any comments about the Adult Catechumenate Program (RCIA)
Concerns		Please let us know if you have any concerns about the Adult Catechumenate Program (RCIA)

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Message	Thank you for completing this form. We will be in contact with you soon. God bless.