RCIA Adult Inquirer Information Form
Please fill out this form and click submit.
Inquirer Information
Name
*
Maiden Name (if applicable)
Email
*
This address will receive a confirmation email
Phone
*
Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Date of Birth
*
Place of Birth (include city, county, state, and country)
*
Religious History
Name of Father (first, middle, and last)
Father's Religion
Name of Mother (first, middle, and maiden)
Mother's Religion
What is your current religious affiliation? Please list "None" if you are not currently affiliated with a specific religion.
*
Have you been baptized?
*
Please select one option.
YES
NO
I am not sure
If you answered yes above, please answer the following questions:
In what denomination were you Baptized (e.g. Catholic; Protestant; Baptist; etc.)
What date or approximate age were you baptized?
What is your baptismal name, if different from your birth name?
Where were you baptized: Church & Religion
Location of Church (if you do not have the street address, please list city, state, and country)
If you were baptized as Catholic, please check any/all of the Sacraments that you have received:
Please select all that apply.
Reconciliation (Confession)
Eucharist (Communion)
Confirmation
Marital Status
Please check the option that applies to you:
*
Please select one option.
I have never been married
I am not married, but I am engaged to be married
I am married
I am married, but currently separated from my spouse
I am divorced and have NOT remarried
I am divorced and have remarried
I am a widow/widower and I have NOT remarried
I am a widow/widower and have remarried
If you checked that you are currently engaged or married, please provide the following information:
Name of FIANCE / SPOUSE
What is the religious affiliation of your FIANCE / SPOUSE?
Is this the first marriage for your FIANCE / SPOUSE?
Please select one option.
YES
NO
I don't know
If you are married, what is the date and place of your marriage?
Were you married in the Catholic Church?
*
Please select one option.
YES
NO
NA
Who was the officiating authority for your marriage?
Please select one option.
Catholic Clergy
Christian Minister
Non-Christian Minister
Civil Clerk/Official
Other
If your spouse is Catholic, but you were married outside the Catholic Church, did you have permission from the Catholic Church?
*
Please select one option.
YES
NO
I don't know
NA
Family Information
Please list the names and ages of any/all children or dependents in your family (e.g. Daughter-Jane, 7 and Son, James, 10 etc.) Please list NONE if you do not have any children/dependents)
*
General Questions
What or who has led you to want to know more about the Catholic Faith?
*
Please describe the type(s) of religious education you have received, as a child or adult. (List NONE if you have not yet received any religious education.)
*
What contact/experiences have you had with the Catholic Church so far?
*
Do you have any concerns or specific questions about the Catholic Church? If yes, please explain.
*
At this point in time, which of the following statements best describes your current feelings and thoughts about joining the Catholic Church?
*
Please select one option.
I need much more information before I can consider joining.
I am considering joining, but I am still unsure.
I am fairly sure that I would like to join, but I need time to pray and discern.
I am ready to begin my preparation to join the Catholic Church.
Submit
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