RCIA Registration Form – St. Aloysius

Personal Information

Your Name*

First Middle Last Maiden

Date of Birth*

Place of Birth*

City State / Province / Region ZIP / Postal Code Country

Father's Full Name*

First Middle Last

Mother's Full Name*

First Middle Last Maiden

Mailing Address*

Street Address Address Line 2 City State ZIP Code

Home/Work Phone

Cell Phone*

Occupation*

Email*

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

Have you ever been baptized?*

In what denomination were you baptized?*

Place of Baptism*

Name of Church/Denomination

If you were baptized as a Catholic, check those sacraments you have already received.*

Check the appropriate statement below and provide any information requested beneath the statement.

Marital Status*

Your Fiancée's Full Name*

First Middle Last

Your Fiancée's Current Religious Affiliation (if any)*

Would this be your Fiancée's first marriage?*

Your Spouse's Full Name*

First Middle Last

Your Spouse's Current Religious Affiliation (if any)*

Have you been married before?*

Would this be your Spouse's first marriage?*

Date of Current Marriage*

Place of Current Marriage*

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Name

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