Inquiry Form

CHRISTIAN INITIATION OF ADULTS

The information below will be kept confidential.

Name_________________________________________________________________________________

(first) (middle) (last) (maiden)

Address_______________________________________________________________________________

(street) (city & state)

Home phone__________________ Cell phone __________________ Work phone__________________

Birth Date______________ Birthplace_______________________________________________________

Father’s name_________________________ Mother’s maiden name_______________________________

Baptized?____ Date:______________ Place:_____________________________________

(Church name - denomination - city - state) Eucharist? ____ Date:______________ Place: ____________________________________

(Church name - denomination - city - state)

Confirmed? ____ Date:______________ Place: ___________________________________________

(Church name - denomination - city - state)

Please provide your baptismal certificate.

Are you presently married? _______

If Yes: Spouse’s name_______________________________________________________________

(first) (middle) (last) (maiden)

Where you married in a church? ________

If yes: Where? ______________________________________________________________________

(church name) (denomination) (city/state)

Have you been previously married?__________ Has your spouse been previously married?____________

Other information regarding marital status:_______________________________________________________

Members of immediate family:

Name Relationship Baptized

For Office Use Only

Godparent(s) name ______________________________________________________________________

Confirmation Sponsor(s) name ____________________________________________________________

Confirmation name(s) ____________________________________________________________________

On reverse side please describe what brought you to this point in your life and what you are seeking from the Church.

Revised 8-2016