RCIA Program 2023-24
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First Name *
Last Name *
Maiden Name (if applicable)
Why are you interested in RCIA? (check as many boxes as apply)
Birthday *
Street Address *
City *
State *
Zip Code *
Phone *
Father's Name
Mother's Name
We meet on MONDAYS during the school year, BEGINNING SEPTEMBER 11, and ending on May 20. There is no obligation or commitment by enrolling in this course (it can be considered an "inquiry class" and a survey course for anyone interested in increasing their knowledge of the Catholic Faith). We do cover all the essentials of Catholic faith and life, and successful completion of the course makes it possible to enter the Catholic Church the Easter Vigil of March 30, 2024, for those ready to do so.
I am generally available to attend the Evening sessions on Monday nights from 7:30  to 9:00 PM, and intend to do so:
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ADDITIONAL COMMENTS (OPTIONAL - Please use the space for any additional questions, special circumstances, or information you would like to share received concerning this RCIA course)
What is your current religious affiliation, if any?
Do you have any previous religious affiliations? If so, which?
Baptism Date
Denomination (Catholic, Lutheran, Episcopalian, etc)
Church of Baptism
Church of Baptism's Address (Street, City, Zip State/Country)
Preferred Language of Instruction
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Could you possibly take the course in English, if instruction in your preferred language were unavailable?
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Marital Status (please check all that are applicable)
If Married, please state how you were married. If married in another Denomination (Lutheran, Episcopalian, etc) please state in 'Other'
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Date or dates of marriage(s)
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