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RCIA Online Registration

- Faith Formation

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- Name and Birth Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden Name (if applicable) Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Place of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Name of Father REQUIRED Please fill out this field. Please enter valid data.
  
  Name of Mother REQUIRED Please fill out this field. Please enter valid data.
- General Information
  
  Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Occupation Please enter valid data.
- Religious History
  
  Present Religious Affiliation REQUIRED Please fill out this field. Please enter valid data.
  
  Have you been baptized? REQUIRED Yes No Not sure Please fill out this field.
  
  If you have been baptized, please provide the following information:
  
  In what denomination were you baptized? Please enter valid data.
  
  Date or Approximate age of Baptism Please enter valid data.
  
  Baptismal Name (if different from your current name) Please enter valid data.
  
  Place of Baptism (name of church/denomination) Please enter valid data.
  
  Address of church (if known) Please enter valid data.
- It is very important for us to receive a copy of your baptismal certificate as soon as possible. If you have any questions or concerns regarding this, please contact Parish Office 913-660-1182
- If you were baptized CATHOLIC, check those sacraments you have already received: Penance (Confession) Eucharist Confirmation
- Current Marital Information
  
  Please select your current marital status REQUIRED Please fill out this field.
  
  If you are engaged to be married, please provide the following information:
  
  Fiance's Name Please enter valid data.
  
  Fiance's current religious affiliation Please enter valid data.
  
  Your Marital History
  
  Your fiance's marital history
  
  If you are married, please provide the following information:
  
  Spouse's Name Please enter valid data.
  
  Spouse's current religious affiliation Please enter valid data.
  
  Your Marital History
  
  Your spouse's marital history
  
  Date of Marriage Please enter valid data.
  
  Place of Marriage (City & State) Please enter valid data.
  
  Form of Marriage
  
  Denomination (if applicable) Please enter valid data.
  
  Officiating Authority of Marriage Please enter valid data.
- Family Information
  
  List the name(s) of any children or other dependant (e.g. daughter, stepson, etc.)
  
  Family Member #1: Name & Age Please enter valid data.
  
  Family Member #2: Name & Age Please enter valid data.
  
  Family Member #3: Name & Age Please enter valid data.
  
  Family Member #4: Name & Age Please enter valid data.
  
  Family Member #5: Name & Age Please enter valid data.
- General Questions
  
  What or who has led you to know more about the Catholic Faith? REQUIRED Please fill out this field.
  
  Please describe the types of religious education you have received as a child and as an adult REQUIRED Please fill out this field.
  
  What contact have you had with the Catholic Church to date? REQUIRED Please fill out this field.
  
  What are some questions or concerns you have about the Catholic Church? REQUIRED Please fill out this field.
  
  At this point in time, which of the following statements best describes your feelings and thoughts about the possibility of joining the Catholic Church REQUIRED Please fill out this field.
- Thank you so much for registering with St. Ann RCIA! You should soon receive a confirmation email with some important information about RCIA at St. Ann.
  
  We will be in contact with you regarding the RCIA process as the new RCIA year approaces.
  
  All information contained in this registration is confidential and will be for official RCIA office use only.
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