RCIA Application

Personal Information

Name*

First Middle Last

Email*

Enter Email Confirm Email

Home Address*

Street Address Address Line 2 City State ZIP Code

Primary Phone*

Secondary Phone

Date of Birth*

Place of Birth*

City State / Province / Region Country

Height (For Confirmation Robe)*

Father's Full Name*

First Middle Last

Mother's Full Maiden Name*

First Middle Maiden Last Name

Do you have any children or other dependents?*

1st Dependent Name and Age*

2nd Dependent Name and Age*

3rd Dependent Name and Age*

4th Dependent Name and Age*

Are you Registered at COTLF?*

Yes
No, I'm Registered at Another Parish
Please register me at COTLF!

COTLF Envelope Number*

At What Church Are You Registered?*

Religious History

Are you Baptized?*

No
Yes, Roman Catholic
Yes, other Christian

Please provide a copy of the applicant's Baptismal Certificate.

Denomination of Baptismal Church*

Date of Baptism*

Name of Church*

Address of Church*

City State / Province / Region Country

Have you Received First Holy Communion?*

No
Yes

Please provide a copy of the applicant's First Communion Certificate.

Date of First Communion*

Name of Church*

Address of Church*

City State / Province / Region Country

RCIA Registration Form

Step 1 of 8

Personal Information

Religious History

Marital Status

Applicant's Previous Marriage(s)

Applicant's Fiance/Fiancee

Applicant's Spouse

Fiance/Fiancee/Spouse's Prior Marriage(s)

Sponsor Information

Final Thoughts