OCIA Inquirer Information Form

Today's Date Today's Date / MM / DD YYYY
Name Name First Middle Last
Maiden Name (If Applicable)
Date Of Birth Date Of Birth / MM / DD YYYY
Age
Must be a number between 18 and 100
Place Of Birth
(include locality [town, city, county, etc.], region [state, province, territory, etc.], and country)

(include locality [town, city, county, etc.], region [state, province, territory, etc.], and country)
Name Of Father
Name OF Mother
I. CONTACT INFORMATION
Full Mailing Address Full Mailing Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone (Daytime) Phone (Daytime) - ### - ### ####
Phone (Evening / Weekend) Phone (Evening / Weekend) - ### - ### ####
Cell / Mobile Phone Cell / Mobile Phone - ### - ### ####
Occupation
Email (Home)
Email (Other)
II. RELIGIOUS HISTORY
1. What, if any, is your present religious affiliation?
2. Have you ever been baptized?

2. Have you ever been baptized? Yes No I am not sure
(a) In what denomination were you baptized?
(b) Date or your approximate age when you were baptized
(c) Baptismal name (if different from current name)
(d) Place of Baptism (name of church / denomination)
(e) Address, if known
(f) Location, if known
(include locality [town, city, county, etc.], region [state, province, territory, etc.], and country)
3. If you were baptized as a Catholic, check those sacraments you have already received.

3. If you were baptized as a Catholic, check those sacraments you have already received. Penance (Confession) Eucharist (First Communion) Confirmation
III. CURRENT MARITAL STATUS
Check the appropriate statement below and provide any information requested beneath the statement.

Check the appropriate statement below and provide any information requested beneath the statement. 1. I have never been married. 2. I am engaged to be married. 3. I am married. 4. I am married, but separated from my spouse. 5. I am divorced and I have not remarried. 6. I am a widow/widower and have not remarried since my spouse’s death.
(a) Your Fiancé(e)’s Name
(b)Your Fiancé(e)’s Current Religious Affiliation (if any)
(c) For you

(c) For you This is my first marriage. I have been married before.
(d) For your fiancé(e)

(d) For your fiancé(e) This is his / her first marriage. My fiancé(e) has been married before.
(a) Your Spouse’s Name
(b) Your Spouse’s Current Religious Affiliation (if any)
(c) For you

(c) For you This is my first marriage. I have been married before.
(d) For your spouse

(d) For your spouse This is my spouse’s first marriage. My spouse has been married before.
(e) Date Of Marriage (e) Date Of Marriage / MM / DD YYYY
(f) Place of Marriage
(include locality [town, city, county, etc.], region [state, province, territory, etc.], and country)
(g) Officiating Authority of Marriage
(civil government, non-Christian minister, Christian minister, Catholic cleric)
IV. FAMILY INFORMATION

List the name(s) of any children or other dependents (e.g., Daughter — Jane; Stepson — John).
Relationship, Name, Age
Relationship, Name, Age
Relationship, Name, Age
Relationship, Name, Age
Relationship, Name, Age
V. GENERAL QUESTIONS
1. What or who has led you to want to know more about the Catholic Faith?
2. Please describe the types of religious education you have received, as a child and as an adult.
3. What contact have you had with the Catholic Church to date?
4. What are some of the questions or concerns you have about the Catholic Church?
5. 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)

5. 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) A. I need much more information about the Catholic Church before I would consider joining. B. I am considering joining, but I am still unsure about it. C. I am fairly sure that I would like to join, but I still need some time to study and pray about it. D. I am fairly sure that I want to join the Catholic Church.

OCIA Inquirer Information Form

OCIA Inquirer Information Form

I. CONTACT INFORMATION

II. RELIGIOUS HISTORY

III. CURRENT MARITAL STATUS

IV. FAMILY INFORMATION

V. GENERAL QUESTIONS