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* Month Day Year City and State of Place of Birth* Contact InformationCurrent Mailing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Preferred Phone Number*Occupation Are you Registered at St. Joseph's?* Yes No CAPTCHAReligious HistoryWhat, 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 StatusCheck the appropriate statement below and provide any information requested beneath the statement.Marital Status* Single Engaged Married Divorced Widow(er) 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* Month Day Year Place of Marriage Additional InformationIn 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?*CommentsThis field is for validation purposes and should be left unchanged.