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RCIA Registration Form

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    Religious Education (CCD)
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    Rite of Christian Initiation of Adults (RCIA)
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    Adult Faith Formation

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- SAINT ELIZABETH SETON CATHOLIC CHURCH
  4900 Reilly Road
  Ocean Springs, Mississippi 39564
- CONTACT 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.
  
  Mailing 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 Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
- PERSONAL INFORMATION
  
  Occupation Please enter valid data.
  
  Marital Status
  
  Name of Spouse / Fiancé(e) Please enter valid data.
  
  If married, is this your first marriage? Yes No
  
  Is an annulment needed? Yes No
  
  Date of Birth Please enter a date.
  
  Place of Birth Please enter valid data.
  
  PARENTS:
  
  Father's Name Please enter valid data.
  
  Mother's Name (include Maiden) Please enter valid data.
- RELIGION INFORMATION
  
  Present Religion Please enter valid data.
  
  Are you baptized? Yes. We will need a copy of your Baptismal Certificate. No
- Please select the most accurate reason for attending this class?
- What members (if any) of this parish do you already know?
- What or who has prompted you to come for instructions at this time?
- Other comments:
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