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RCIA Registration

RCIA REgistration
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  This registration form is for those inquiring about joining the Catholic Church and for those who have finished their inquiry period and are ready to take the next steps. Please fill in as much of this form as you are able. If you have questions, please email Mary at mallison@st.patsak.org
  
  Name REQUIRED Please fill out this field. Please enter valid data.
  
  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 (parent phone number if under 19) REQUIRED Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Place of Birth
  
  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.
  
  Birthdate REQUIRED Please fill out this field. Please enter a date.
  
  Father's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Maiden Name REQUIRED Please fill out this field. Please enter valid data.
  
  Confirmation Saint (if known) Please enter valid data.
  
  Religious History
  
  Which major world religion are you currently?
  
  Are you currently Mormon or a Jehovah's Witness? Yes No
  
  If you chose Christian above, in which denomination were you raised?
  
  Were you baptized in one of the above Christian denominations? Yes No
  
  Godparent's/Sponsor's Information
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Address Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  Phone Number Please enter a phone number.
  
  Other Godparent's Name Please enter valid data.
  
  Address Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  Phone Number Please enter a phone number.
  
  Submit
  
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