RCIA Inquirer Information Form

Date*
MM slash DD slash YYYY
Name*
First Middle Last
Maiden Name (if applicable)
First Last
Date of Birth*
MM slash DD slash YYYY
Place of Birth*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

What, if any, is your present religious affiliation?*
Have you ever been baptized?*
In what denomination were you baptized?*
When were you baptized? (Approximate date or age)*
Where were you baptized? (Church/denomination)*
Address of church (if known)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
If you were baptized as a Catholic, please check the sacraments that you have received.
- Penance (Confession)
- Eucharist (First Communion)
- Confirmation

What is your current marital status?*
Please check the one statement that best describes your current status.
Your Fiance(e)'s name*
First Last
Your Fiance(e)'s current religious affiliation (if any)
Please select the option that describes your current status
Date of your prior marriage
MM slash DD slash YYYY
Place of your prior marriage
Please select the option that describes your fiance(e)'s status
Date of your fiance(e)'s prior marriage
MM slash DD slash YYYY
Place of your fiance(e)'s marriage
Your Spouse's name*
First Last
Your spouse's current religious affiliation (if any)
Please select the option that describes your status
Date of your prior marriage*
MM slash DD slash YYYY
Place of your prior marriage
Please select the option that describes your spouse's status
Date of your spouse's prior marriage*
MM slash DD slash YYYY
Place of your spouse's prior marriage