RCIA Registration

Personal Information/ Informacion Personal:

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

Last Name REQUIRED Please fill out this field. Please enter valid data.

Address/ Direccion REQUIRED Please fill out this field. 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 REQUIRED Please fill out this field. Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

Date of Birth/ Fecha de Nacimiento REQUIRED Please fill out this field. Please enter valid data.

Place of Birth (City & State)/ Lugar de Nacimiento (Ciudad y Estado): REQUIRED Please fill out this field. Please enter valid data.

Family Information:

Father's Name/ Nombre del Padre: REQUIRED Please fill out this field. Please enter valid data.

His Religion/ Religion del Padre: Please enter valid data.

Mother's Maiden Name/ Nombre de Soltera de Madre: REQUIRED Please fill out this field. Please enter valid data.

Her Religion/ Religion de Madre Please enter valid data.

Do you have any children?/Tiene Hijos? REQUIRED Please fill out this field.

Marital Information: REQUIRED I have never been married/Nunca he estado casado I am married/Estoy casado(a) I am presently separated/Estoy separado(a) I am a widow(er)/Soy viudo(a) I am divorced and remarried/Estoy divorciado y vuelto a casar I am divorced and NOT remarried/Estoy divrociado y NO vuelto a casar Please fill out this field.

Sacrament Received/Sacramentos Recibidos REQUIRED Baptized/Bautizo First Communion/Primera Comunion Confirmation/Confirmacion Marriage/Matrimonio None/Ninguno Please fill out this field.

If you've already been baptized, which faith denomination? (ie: Catholic, Methodist, etc.) If you are seeking baptism, please answer N/A. REQUIRED Please fill out this field. Please enter valid data.

Would you like to attend class in/Desea asistir a clase en REQUIRED English/Ingles Spanish/Espanol Please fill out this field.

St. Francis of Assisi Catholic Church

United in our catholic faith, we strive to love and serve God as Jesus did.

RCIA Registration

RCIA Registration form

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