OCIA Adult Inquirer &lt;br&gt;Information Form

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Date REQUIRED Please fill out this field. Please enter a date.
First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Middle Name Please enter valid data.
Date of Birth Please enter a date.
Place of Birth
Include city, state, and county
Please enter valid data.
Name of Father Please enter valid data.
Name of Mother Please enter valid data.
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1. CONTACT INFORMATION
Mailing Address Please enter valid data.
City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.
Phone Number Daytime Maximum 20 characters Please enter a phone number.
Phone Number Evening - Weekend Maximum 20 characters Please enter a phone number.
Cell Phone Number Maximum 20 characters Please enter a phone number.
Occupation Please enter valid data.
Email REQUIRED Please fill out this field. Please enter an email address.
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2. RELIGIOUS HISTORY
Present Religious Affiliation - if any Please enter valid data.
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Baptized? Yes No Not Sure
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If you answered "Yes" to being baptized, please provide the following information:
In what denomination were you baptized? Please enter valid data.
Date or Approximate Age When Baptized Please enter valid data.
Baptismal Name Please enter valid data.
Place of Baptism Please enter valid data.
Address if Known Please enter valid data.
Location if Known
Include city, state, and country
Please enter valid data.
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If you were baptized as a Catholic, check the following sacraments you have already received:
Sacraments Received
Check all that apply!
Penance (Confession) Eucharist (First Communion) Confirmation
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3. CURRENT MARITAL STATUS
Marital Status REQUIRED Please fill out this field.
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If you are engaged please complete the following:
Fiance's Name Please enter valid data.
Fiance's Current Religious Affiliate Please enter valid data.
For You - Have you been married before? First Marriage I've been Married Before
Has Your Fiance Been Married Before? First Marriage for Fiance My Fiance has been Married Before
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If you are married please complete the following:
Spouse's Name Please enter valid data.
Spouse's Current Religious Affiliate Please enter valid data.
For You - Have you been married before? First Marriage I've been Married Before
Has Your Spouse Been Married Before? First Marriage for Spouse My Spouse has been Married Before
Date of Marriage Please enter a date.
Place of Marriage
Include city, state, and country
Please enter valid data.
Officiating Authority of Marriage
Include city, state, and country
Please enter valid data.
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4. FAMILY INFORMATION
List the name(s) of any children or other dependents
- How Many Dependents REQUIRED Please fill out this field.
- Dependents 1
  - Relationship Please enter valid data.
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Age Please enter an integer (number).
- Dependents 2
  - Relationship Please enter valid data.
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Age Please enter an integer (number).
- Dependents 3
  - Relationship Please enter valid data.
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Age Please enter an integer (number).
- Dependents 4
  - Relationship Please enter valid data.
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Age Please enter an integer (number).
- Dependents 5
  - Relationship Please enter valid data.
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Age Please enter an integer (number).
- Dependents 6
  - Relationship Please enter valid data.
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Age Please enter an integer (number).
- Dependents 7
  - Relationship Please enter valid data.
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Age Please enter an integer (number).
- Dependents 8
  - Relationship Please enter valid data.
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Age Please enter an integer (number).
- Dependents 9
  - Relationship Please enter valid data.
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Age Please enter an integer (number).
- Dependents 10
  - Relationship Please enter valid data.
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Age Please enter an integer (number).
- Dependents 11
  - Relationship Please enter valid data.
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Age Please enter an integer (number).
- Dependents 12
  - Relationship Please enter valid data.
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Age Please enter an integer (number).
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5. GENERAL QUESTIONS
What or who has led you to want to know more about the Catholic Faith?
Please describe the types of religious education you have received, as a child and as an adult?
What contact have you had with the Catholic Church to date?
What are some of the questions or concerns you have about the Catholic Church?
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At this point in time, which of the following statements best describes your present feelings and thoughts about the possibility of joining the Catholic Church? (Please select one)
Best describes me at this point in time REQUIRED I need much more information about the Catholic Church before I would consider joining. I am considering joining, but I am still unsure about it. I am fairly sure that I would like to join, but I still need some time to study and pray about it. I am fairly sure that I want to join the Catholic Church. Please fill out this field.
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Queen of the Holy Rosary - Wea	Parish	School
22779 Metcalf Rd.	p. (913) 533-2464	p. (913) 533-2462
Bucyrus, KS 66013	e. [email protected]	e. [email protected]

OCIA Adult Inquirer Information Form

OCIA Adult Inquirer
Information Form