JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
RCIA Information 2021-2022
Complete all areas that apply. You will need to supply a birth certificate and/or a baptism certificate if baptized.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Status
Catechumen - Need the Sacraments of Baptism, First Communion, and Confirmation
Candidate - Needs the Sacrament of First Communion and Confirmation only
Need the Sacrament of Confirmation Only
Clear selection
Today's Date
MM
/
DD
/
YYYY
Date of Birth
MM
/
DD
/
YYYY
Last Name
Your answer
First Name
Your answer
Middle Name
Your answer
Cell Phone
Your answer
Address include city and state and zip code
Your answer
Gender
Male
Female
Marital Status-Important If you are "coupled," you will need to set a wedding date within six months of reception of the sacraments.
Married and separated
Divorced
Married in a non-Catholic church
Coupled-Living together in an intimate relationship. You need to see a priest.
Single-If you are living together intimate relationship, you are not single
Married Catholic Church
Divorced and remarried and planning to marry.
Civil Marriage - See a priest to have your marriage blessed.
Clear selection
If married in the Catholic Church, enter the date
MM
/
DD
/
YYYY
If married in the Catholic Church, Name of church and address (Your will need your marriage certificate)
Your answer
Have you been baptized?
Yes
No
Clear selection
If you have been baptized, enter the date
MM
/
DD
/
YYYY
If you have been baptized, enter the name and address of the church (You will need to provide your baptismal certificate)
Your answer
Have you made your First Communion?
Yes
No
Clear selection
If you have made your First Communion, enter the date
MM
/
DD
/
YYYY
If you have made your First Communion, enter the name and address of the church
Your answer
Have you been Confirmed?
Yes
No
Clear selection
If you have been Confirmed, enter the date
MM
/
DD
/
YYYY
If you have been Confirmed, enter the church name and address
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
