RCIA Registration – English - Our Lady Help of Christians

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Date of Birth REQUIRED Please fill out this field. Please enter valid data.

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.

Email (You will receive an email confirmation) REQUIRED Please fill out this field. Please enter an email address.

Home Phone Please enter a phone number.

Cell Phone REQUIRED Please fill out this field. Please enter a phone number.

Work Phone Please enter a phone number.

I am: REQUIRED Baptized (Non-Catholic) Baptized Catholic Not Baptized Please fill out this field.

If you are Baptized Non-Catholic, what denomination were you baptized? Please enter valid data.

Martial Status - I am: REQUIRED Single Married in Catholic Church Married Non-Catholic marriage Divorced Please fill out this field.

If you were not married in Catholic Church, who married you? Please enter valid data.

Select all that apply: I would like more information about the Catholic Faith I am a Catholic and would like to receive Eucharist & Confirmation I am a Catholic and would like to receive the Sacrament of Confirmation. I have questions and would like someone to call me. I am a Catholic and would like to learn more about the Faith.

Questions/Comments:

Our Lady Help of Christians

• Bringing All to Christ •
Sharing Christ With All • Being One In Christ

RCIA Registration – English

Downloadable Form

Catholicism for adults (CA) & RCIA Online Registration Form