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RCIA Registration
Pre-Initiation Inventory
The maximum number of form submissions has been reached. This form is currently not available.
A. Inquirer Data
Date
REQUIRED
Please fill out this field.
Please enter a date.
First Name
REQUIRED
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Please enter valid data.
Middle Name
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Last Name
REQUIRED
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Address
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City
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State
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Zip
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Phone Number
REQUIRED
Maximum 20 characters
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Please enter a phone number.
Email
REQUIRED
Please fill out this field.
Please enter an email address.
Are you active military?
Yes
No
If so, will you deploying out of the area before 31 March 2024?
Yes
No
B. Place and Date of Birth
City of Birth
REQUIRED
Please fill out this field.
Please enter valid data.
Date of Birth
REQUIRED
Please fill out this field.
Please enter valid data.
State of Birth
REQUIRED
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Please enter valid data.
C. Father's Information
Father's First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Father's Middle Name
REQUIRED
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Please enter valid data.
Father's Last Name
REQUIRED
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Please enter valid data.
Father's Address
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City
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State
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KY
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MH
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NC
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NM
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Zip
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Father's Religion
Please enter valid data.
Father's Phone Number
Maximum 20 characters
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Father's Email
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D. Mother's Information
Mother's First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Mother's Middle Name
REQUIRED
Please fill out this field.
Please enter valid data.
Mother's Last Name (Maiden)
REQUIRED
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Mother's Address
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City
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State
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KY
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MH
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MN
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Zip
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Mother's Religion
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Mother's Phone Number
Maximum 20 characters
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Mother's Email
Please enter an email address.
Sacrament Information
E. Baptism
If you were NOT baptized, check "No," and skip down to the RCIA Section.
Were you Baptized?
Yes
No
If yes, Date of Baptism
Please enter valid data.
If yes, what is the Religion of the Church? (Submit a copy of your Baptismal Certificate or letter from the church of baptism.)
Please enter valid data.
Name of the Church
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Church's Address
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City
Please enter valid data.
State
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ID
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KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
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OK
OR
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PR
PW
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SC
SD
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UT
VA
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WV
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Zip
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F. Confirmation
(Only fill this section if you were baptized. Otherwise, skip down to the Current Life Status)
Were you Confirmed?
Yes
No
If yes, Date of Confirmation
Please enter valid data.
Name of the Church
Please enter valid data.
If yes, what is the Religion of the Church?
Please enter valid data.
Church's Address
Please enter valid data.
City
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State
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AL
AR
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AZ
CA
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CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Zip
Please enter a zip code.
G. First Holy Communion
(Only fill this section if you were baptized. Otherwise, skip down to the Current Life Status)
Have you ever received First Holy Communion?
Yes
No
If yes, Date of First Holy Communion
Please enter valid data.
If yes, what is the Religion of the Church?
Please enter valid data.
Name of the Church
Please enter valid data.
Church's Address
Please enter valid data.
City
Please enter valid data.
State
None
AK
AL
AR
AS
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CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Zip
Please enter a zip code.
H. RCIA
(Rite of Christian Initiation for Adults)
Have you ever been previously accepted as a candidate/catechumen the Catholic Church?
Yes
No
Name of Roman Catholic Church where you had been in RCIA
Please enter valid data.
Church's Address
Please enter valid data.
City
Please enter valid data.
State
None
AK
AL
AR
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CT
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DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Zip
Please enter a zip code.
Reason(s) for not completing the RCIA Program:
I. Current Life (Which best describes your status?)
REQUIRED
(Select One)
Single-never been married
Single, but engaged to be married
Married in the Roman Catholic Church by a priest or deacon
Married, but NOT in the Roman Catholic Church
Previously married, divorced, not remarried
Previously married and divorced, but engaged to be married
Remarried with a Church annulment
Remarried WITHOUT a Church annulment
Separated - Civilly (legally) or mutual choice by both parties
Widow(er) and NOT intending to marry again
Widow(er), engaged to be married
Widow(er), intending to marry again
Please fill out this field.
J. We're Engaged! ONLY fill out this section if:
Single, but engaged to be married
Previously married and divorced, but engaged to be married
Widow(er), engaged to be married
Is this wedding happening before 31 March 2024?
Yes
No
Future Spouse's Name
Please enter valid data.
Future Spouse's Religion
Please enter valid data.
Place of Pre-Marriage Preparation
Please enter valid data.
Date of Wedding
Please enter valid data.
Wedding Venue
Roman Catholic Church
Non-Catholic Church
Before Civil Official
Name of the place where the wedding will take place
Please enter valid data.
Street address where the wedding will take place
Please enter valid data.
City
Please enter valid data.
State
None
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Zip
Please enter a zip code.
Prior to this impending wedding, were you ever been married to another person in church, civilly or by common law? If you answer YES, Fill out Section K.
Yes
No
Prior to this impending wedding, was your future spouse's ever been married to another person in church, civilly or by common law? If you answer YES, Fill out Section L.
Yes
No
K. Marriage - List all your marriage(s) [civilly, church, or common law], starting with your first and ending with your current marriage If:
Previously married and divorced, but engaged to be married
Remarried WITHOUT a Church annulment
Married in the Roman Catholic Church by a priest or deacon
Married, but NOT in the Roman Catholic Church
Remarried with a Church annulment
Separated - Civilly (legally) or mutual choice by both parties
How many times have you been married?
REQUIRED
Please fill out this field.
Marriage # 1
Spouse's Name
Please enter valid data.
Spouse's Religion
Please enter valid data.
Date of the Wedding
Please enter valid data.
Wedding Venue
Roman Catholic Church
Non-Catholic Church
Before Civil Official
Name of the place where the wedding took place
Please enter valid data.
Street address where the wedding took place
Please enter valid data.
City
Please enter valid data.
State
None
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Zip
Please enter a zip code.
Was this marriage Convalidated? This means the couple came to the Catholic Church after being married outside the Church, did a Catholic marriage preparation program, and had a Catholic ceremony in the church to convalidate the marriage.)
Yes
No
Officiant
Please enter valid data.
Status of this marriage?
Still Married to this Spouse
Divorce
Death
If this was a previous marriage, was it annulled, and who issued the annulment?
Catholic Church
Civil Court
Marriage # 2
Spouse's Name
Please enter valid data.
Spouse's Religion
Please enter valid data.
Date of the Wedding
Please enter valid data.
Wedding Venue
Roman Catholic Church
Non-Catholic Church
Before Civil Official
Name of the place where the wedding took place
Please enter valid data.
Street address where the wedding took place
Please enter valid data.
City
Please enter valid data.
State
None
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Zip
Please enter a zip code.
Was this marriage Convalidated? This means the couple came to the Catholic Church after being married outside the Church, did a Catholic marriage preparation program, and had a Catholic ceremony in the church to convalidate the marriage.)
Yes
No
Officiant
Please enter valid data.
Status of this marriage?
Still Married to this Spouse
Divorce
Death
If this was a previous marriage, was it annulled, and who issued the annulment?
Catholic Church
Civil Court
Marriage # 3
Spouse's Name
Please enter valid data.
Spouse's Religion
Please enter valid data.
Date of the Wedding
Please enter valid data.
Wedding Venue
Roman Catholic Church
Non-Catholic Church
Before Civil Official
Name of the place where the wedding took place
Please enter valid data.
Street address where the wedding took place
Please enter valid data.
City
Please enter valid data.
State
None
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Zip
Please enter a zip code.
Was this marriage Convalidated? This means the couple came to the Catholic Church after being married outside the Church, did a Catholic marriage preparation program, and had a Catholic ceremony in the church to convalidate the marriage.)
Yes
No
Officiant
Please enter valid data.
Status of this marriage?
Still Married to this Spouse
Divorce
Death
If this was a previous marriage, was it annulled, and who issued the annulment?
Catholic Church
Civil Court
L. Your Spouse's Previous Marriage(s) fill out this section if:
Â
Married, but NOT in the Roman Catholic Church
Previously married and divorced, but engaged to be married
Remarried WITHOUT a Church annulment
Widow(er), engaged to be married
Â
How many times has current or Former Spouse(s) been married?
REQUIRED
Please fill out this field.
Marriage # 1
Your Spouse's Name
Please enter valid data.
His/Her Former Spouse's Name
Please enter valid data.
His/Her Former Spouse's Religion
Please enter valid data.
Date of Previous Wedding
Please enter valid data.
Wedding Venue
Roman Catholic Church
Non-Catholic Church
Before Civil Official
Name of the place where the wedding took place
Please enter valid data.
Street address where the wedding took place
Please enter valid data.
City
REQUIRED
Please fill out this field.
Please enter valid data.
State
REQUIRED
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Please fill out this field.
Zip
REQUIRED
Please fill out this field.
Please enter a zip code.
Was this marriage Convalidated? This means the couple came to the Catholic Church after being married outside the Church, did a Catholic marriage preparation program, and had a Catholic ceremony in the church to convalidate the marriage.)
Yes
No
Officiant
Please enter valid data.
How did this Marriage end?
Divorce
Death
If this marriage was annulled, who issued the annulment?
Catholic Church
Civil Court
Marriage # 2
Your Spouse's Name
Please enter valid data.
His/Her Former Spouse's Name
Please enter valid data.
His/Her Former Spouse's Religion
Please enter valid data.
Date of Previous Wedding
Please enter valid data.
Wedding Venue
Roman Catholic Church
Non-Catholic Church
Before Civil Official
Name of the place where the wedding took place
Please enter valid data.
Street address where the wedding took place
Please enter valid data.
City
REQUIRED
Please fill out this field.
Please enter valid data.
State
REQUIRED
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Please fill out this field.
Zip
REQUIRED
Please fill out this field.
Please enter a zip code.
Was this marriage Convalidated? This means the couple came to the Catholic Church after being married outside the Church, did a Catholic marriage preparation program, and had a Catholic ceremony in the church to convalidate the marriage.)
Yes
No
Officiant
Please enter valid data.
How did this Marriage end?
Divorce
Death
If this marriage was annulled, who issued the annulment?
Catholic Church
Civil Court
Marriage # 3
Your Spouse's Name
Please enter valid data.
His/Her Former Spouse's Name
Please enter valid data.
His/Her Former Spouse's Religion
Please enter valid data.
Date of Previous Wedding
Please enter valid data.
Wedding Venue
Roman Catholic Church
Non-Catholic Church
Before Civil Official
Name of the place where the wedding took place
Please enter valid data.
Street address where the wedding took place
Please enter valid data.
City
REQUIRED
Please fill out this field.
Please enter valid data.
State
REQUIRED
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Please fill out this field.
Zip
REQUIRED
Please fill out this field.
Please enter a zip code.
Was this marriage Convalidated? This means the couple came to the Catholic Church after being married outside the Church, did a Catholic marriage preparation program, and had a Catholic ceremony in the church to convalidate the marriage.)
Yes
No
Officiant
Please enter valid data.
How did this Marriage end?
Divorce
Death
If this marriage was annulled, who issued the annulment?
Catholic Church
Civil Court
Marriage # 4
Your Spouse's Name
Please enter valid data.
His/Her Former Spouse's Name
Please enter valid data.
His/Her Former Spouse's Religion
Please enter valid data.
Date of Previous Wedding
Please enter valid data.
Wedding Venue
Roman Catholic Church
Non-Catholic Church
Before Civil Official
Name of the place where the wedding took place
Please enter valid data.
Street address where the wedding took place
Please enter valid data.
City
REQUIRED
Please fill out this field.
Please enter valid data.
State
REQUIRED
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Please fill out this field.
Zip
REQUIRED
Please fill out this field.
Please enter a zip code.
Was this marriage Convalidated? This means the couple came to the Catholic Church after being married outside the Church, did a Catholic marriage preparation program, and had a Catholic ceremony in the church to convalidate the marriage.)
Yes
No
Officiant
Please enter valid data.
How did this Marriage end?
Divorce
Death
If this marriage was annulled, who issued the annulment?
Catholic Church
Civil Court
Feel free to add anything you feel would be important for the RCIA team to know.
Submit
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