RCIA Registration Form

Saint Boniface Parish RCIA Registration Form

(Rite of Christian Initiation of Adults)

Information on this form is held in confidence, and is not shared without your permission.

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

Name

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

Last Name REQUIRED Please fill out this field. Please enter valid data.
Maiden Name (if Applicable Please enter valid data.
Date of Birth REQUIRED Please fill out this field. Please enter a date.
Place of Birth: (City, State, Country) Please enter valid data.
Father's Full Name REQUIRED Please fill out this field. Please enter valid data.
Mother's Full Maiden Name REQUIRED Please fill out this field. Please enter valid data.

Contact Information

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 Maximum 20 characters Please enter a phone number.
Cell Phone Maximum 20 characters Please enter a phone number.

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

Religious History

Please provide a copy of Sacramental certificates, regardless of religious affiliation)

1. What, if any, is your present religious affiliation? Please enter valid data.

2. Have you ever been baptized? Yes No I am not sure

If you answered "Yes" to Question 2, please provide the following information:

a. In what denomination were you baptized" Please enter valid data.

b. Place of Baptism (Name of Church and Location) Please enter valid data.

If you were baptized as a Catholic, check those sacaments you have already received Penance (Confession) Eucharist (First Communion) Confirmation

Current Marital Status

Number of Children REQUIRED Please fill out this field.
Child 1
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Age Please enter an integer (number).
Child 2
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Age Please enter an integer (number).
Child 3
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Age Please enter an integer (number).
Child 4
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Age Please enter an integer (number).
Child 5
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Age Please enter an integer (number).
Child 6
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Age Please enter an integer (number).
Child 7
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Age Please enter an integer (number).
Child 8
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Age Please enter an integer (number).
Child 9
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Age Please enter an integer (number).
Child 10
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Age Please enter an integer (number).

General Questions

1. Please describe your own religious education or church background
2. How have you come to be interested in the Catholic Church?
3. Is there one person in particular who is responsible for your interest in the Catholic Church? Will that person be acting as your Sponsor, and walking this journey with you?

Sponsor must be 16 years of age or older, a Confirmed Catholic, attendending Mass, and actively participating in the sacramental life of the Catholic Church.