Request edit access
(Rite of Christian Initiation of Adults) RCIA Registration
We welcome you as you begin the process of looking into and considering the teachings of the Roman Catholic Church. The first thing we ask of you is that you complete the online questionnaire.

The questionnaire is designed to help us get to know you and your particular situation, so we may serve you better. Each question is asked for a particular purpose, even if that purpose may not apply to you specifically, so please answer each question carefully and completely.

If you have any questions please contact St. Anselm RCIA Coordinator,
Melanie Arnold MA Theology 985-845-7342.

May the Lord bless you and be with you as you seek His will for your life.

Pax Christi


Dome of St. Peter's in Rome, Italy
Adult Inquirer Basic Information
Thank you for providing St. Anselm with information needed to best serve you in your journey.
First Name *
Your answer
Middle Name *
Your answer
Last Name *
Your answer
Maiden Name *
(if NOT applicable please put N/A)
Your answer
Date of Birth *
Example: March 25, 2016
MM
/
DD
/
YYYY
Age *
Your answer
Place of Birth *
Town, State, Country
Your answer
Name of Father *
Your answer
Name of Mother *
Your answer
Mother's Maiden Name *
This is required in order to record your Baptism.
Your answer
Are you Male or Female *
What is your Occupation?
Your answer
Mailing Address Street *
Your answer
Mailing Address City *
State and Zip Code *
Email Address *
Your answer
Cell Phone Number *
Your answer
Additional Phone Number
Your answer
Marital Information *
If you would like to discuss this information with a Priest or Deacon please contact St. Anselm Parish Office at 985-845-7342 to make an appointment.
Required
Spouse's/Fiancé Full Name *
(if NOT applicable please put N/A)
Your answer
Spouse's/Fiancé Current Religion *
(if NOT applicable please put N/A)
Your answer
Spouse/Fiancé Marital Information *
Children's Names/Ages
Your answer
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms