St. Teresa Benedicta of the Cross RCIA REGISTRATION

The following information is confidential.

Personal Data

Text Box: Date _________________ Full Name_____________________________________________________________ Prefered Name________________________ Address_________________________________________ ZIP _______ Home Phone _____________ Cell Phone ______________ Place of Employment ___________________________________ Occupation ___________________ Work Phone ______________ Email Address ______________________________________ Current Religion: ________________________________________ How would you describe your interest in attending our inquiry sessions? I am "just looking" to see what the Catholic Church has to offer. I have a number of questions or problems that will need to be resolved before I think of becoming a Catholic. I am thinking about becoming a Catholic, but I need more time and information before making a commitment. I am convinced that I want to become a Catholic. If you selected any of the above, please complete the entire form, if one of the three below you may stop after this boxed section. I am Catholic and want to grow in my faith. I am Catholic and came to be with my friend/fiance(e)/spouse. His/her name: ______________________________________ I am Catholic and want to be a companion, sponsor, or RCIA team member. Is there someone whom you would like to have as your sponsor? _______________________________________________________ Hobbies & Interests:__________________________________________________________________________________________ ___________________________________________________________________________________________________________

 

Family Data

Text Box: Place of Birth_______________________________________________________________________ Birthdate _______________ Father's full name____________________________________________________________________________________________ Mother's full name___________________________________________________________________________________________ Name of fiance(e) or spouse ____________________________________________________________________________________ Children's names and birthdates:________________________________________________________________________________ ___________________________________________________________________________________________________________

 

Baptism

Text Box: Were you baptized? ______ Date of Baptism __________________ Denomination ________________________________________ Name and location of church___________________________________________________________________________________ Degree of involvement with this church: 0 (none) 1 2 3 4 5 (strong) What did your baptism mean to you? Describe the experience: ________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________

 

Confirmation

Text Box: Were you confirmed? _____ Date of Confirmation ________________ Denomination _____________________________________ Name and location of church___________________________________________________________________________________ Degree of involvement with this church: 0 (none) 1 2 3 4 5 (strong)


Marriage

Text Box: Marital Status: Single ______ Engaged ______ Married ______ Divorced ______ Widowed ______ Where were you married? ________________________________________________ Date ________________________________ Is this your first marriage? Yes ______ No ______ Is this your spouse's first marriage? Yes _____ No _____ Helpful information regarding previous marriage(s): ________________________________________________________________ ___________________________________________________________________________________________________________

 

Background

Text Box: Describe your religious education/background:_____________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ Do you attend Catholic worship services regularly?__________________________________________________________________ Which Mass and Parish do you normally attend?__________________________________________________________________ What has been your experience of the Catholic Church? _____________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ Who or what prompted you to take this look at the Catholic Church? ___________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ What members of St. Teresa do you know?________________________________________________________________________ ___________________________________________________________________________________________________________ Any other information about your background or life experience that would be helpful for the Pastoral Staff to know? ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ What questions do you have?___________________________________________________________________________________ ___________________________________________________________________________________________________________