RCIA Registration Form – St. Joseph's on Capitol Hill

This information will be used to record your sacrament.

Registrant's Name*

Person Registering for RCIA

First Middle Last (& Maiden Name if Applicable)

Father's Name*

First Last

Mother's Name*

First Last

Date of Birth of Registrant*

City and State of Place of Birth*

Contact Information

Current Mailing Address*

Street Address Address Line 2 City State ZIP Code

Email*

Preferred Phone Number*

Occupation

Are you Registered at St. Joseph's?*

Yes
No

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Religious History

What, if any, is your present religious affiliation?

Have you been baptized?*

Yes
No

Denomination?*

Approximate Age (in years) at Baptism*

Please enter a number from 0 to 100.

Place (Church Name and Address)*

If Catholic, Sacraments Received*

Confession
First Eucharist
Confirmation

Current Marital Status

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

Marital Status*

Fiance's Name*

First Middle Last

Your fiance's current religious affiliation (if any)

For you:

This is my first marriage
I have been married before

For your fiance:

This is his/her first marriage
He/she has been married before

Your spouse's name

First Middle Last

Your spouse's current religious affiliation (if any)

For you:

This is my first marriage
I have been married before

For your spouse:

This is his/her first marriage
He/she has been married before

Date of Marriage*

Place of Marriage

Additional Information

In order for us to better help you to grow in faith please provide us with answers to the following.

Tell us why you enrolled in RCIA*

What is your image of God?*

Do you have specific questions about the Catholic Faith?*

What has brought you to St. Joseph's and the Washington, D.C. area?*

Name

This field is for validation purposes and should be left unchanged.