OCIA Registration Form

Name*

First Middle Last Maiden (If Applicable)

Date of Birth*

Age*

Place of Birth*

Father's Full Name*

Mother's Full Name*

(Please include maiden name)

Contact Information

Mailing Address*

Street Address Address Line 2 City State ZIP Code

Home Phone*

Cell Phone*

Email Address*

Religious History

Please provide a copy of Sacramental certificates, regardless of religious affiliation by sending them to the parish office, if applicable

What, if any, is your present religious affiliation?*

Have you ever been baptized?*

Yes
No
I am not sure.

In what denomination were you baptized?*

Place of Baptism

If you were baptized Catholic, check those sacraments you have already received

Penance (Confession)
Eucharist (First Communion)
Confirmation

Current Marital Status

(You must provide a copy of marriage certificate, civil divorce decree, and annulment, if applicable) Check the appropriate statement(s) below and provide any information requested beneath the statement(s)

Marital Status*

I have never been married
I am engaged to be married
I am married
I am married, but separated from my spouse
I am divorced and I have not remarried
I am widowed and I have not remarried

Do you have children?*

Yes
No

Engagement Info

Your Fiancé's Full Name*

Your Fiancé's Current Religious Affiliation (if none, put N/A)*

For you:*

This is my first marriage
I have been married before.

Please indicate how that marriage was resolved (divorced, annulled)

For your Fiancé:*

This is my fiancé’s first marriage
My fiancé have been married before.

Please indicate how that marriage was resolved (divorced, annulled)

Married Info

Your Spouse's Full Name*

Your Spouse's Current Religious Affiliation (if none, put N/A)*

For you:*

This is my first marriage
I have been married before.

Please indicate how that marriage was resolved (divorced, annulled)

For your Spouse:*

This is my spouse’s first marriage
My spouse have been married before.

Please indicate how that marriage was resolved (divorced, annulled)

Date of Marriage*

Place of Marriage*

Children Info

Children*

Add additional children information with the plus button

Name	Age	Relationship

General Questions

Please describe your own religious education or church background*

How have you come to be interested in the Roman Catholic Church?*

Do you have any questions that you would like answered at this time?

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?*

(A Sponsor must be 16 years of age or older, a Confirmed Catholic, attending Mass, and actively participating in the sacramental life of the Catholic Church)

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