RCIA REGISTRATION FORM

(Please Print)

Last Name:_________________________ First Name:_____________________ Middle Initial:______

Address:________________________________________ E-mail:_____________________________

City:_______________________________________ State:___________ Zip Code:________________

Date of Birth:___________________ Place of Birth:________________________________________

Home Phone:___________________________ Cell/Work Phone:_____________________________

Father's Full Name:_______________________________________	Father's Religion:______________

Mother's First & Maiden Name:_____________________________	Mother's Religion:_____________

Baptized? (Yes/No):_________ Certificate checked by:_______________________________________

Church of Baptism:_______________________________________ Date of Baptism:_______________

Church Address:______________________________________________________________________

City:_______________________________________ State:__________ Zip Code:_________________

Marital History: Please state what your current marital status is. Please include a brief marital history, information about former marriages, etc. Please include spouse name, dates and places of marriages, stating whether they were civil or church weddings. If they were church weddings, please give the church name and location:

Did you receive:

First Communion? (Yes/No):______ Date/Place:____________________________________________

Confirmation? (Yes/No):_______ Date/Place:______________________________________________

Registered Member of St. Francis Parish: □

Baptism Godparent or Confirmation Sponsor:_______________________________________________

Godparent's or Sponsor's Telephone:_____________________E-mail:___________________________

Confirmation Name:___________________________________________________________________

□ Baptism	□ Full Communion	□ To Complete Initiation □ Already Fully Initiated (Updating)

Registration Fee ($40) Paid □

Baptism requires a Godparent, who cannot be your parent, spouse, or spouse's parent. Confirmation requires a Sponsor, who cannot be your parent. Godparents and Sponsors must be Confirmed Catholics in good standing (i.e. attending Mass regularly) and able to obtain a letter of recommendation from their parish (unless they are a member of St. Francis of Assisi).