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?___________________________________________________________________________________
___________________________________________________________________________________________________________