Adult Catechism Inquiry Form Adult Catechism Inquiry Form All information provided on this form is held in confidence. The information is used only to assist in the process of bringing you into full communion with the Catholic Church. Name * Name First & Middle Names First & Middle Names Last Name Last Name Father’s Name * Father's Name First & Middle Names First & Middle Names Last Name Last Name Mother’s Maiden Name * Mother's Maiden Name First & Middle Names First & Middle Names MAIDEN Name MAIDEN Name Email * Phone * Age * Date of Birth * Place of birth * City, state & country Home Address * Home Address Home Address Home Address City City State/Province State/Province Zip/Postal Zip/Postal Religious History What, if any, is your present religious affiliation? * Have you ever been baptized? * Yes No Unsure If yes, in what denomination were you baptized? * Name of Place of Baptism * Name of church or place Location of Baptism * City & State (and country if not the US) If you were baptized as a Catholic, which sacraments have you already received? Penance/Confession Eucharist/First Communion Confirmation Marital Status Please select the appropriate statement below and provide any information requested beneath the statement. * I nave never been married I am engaged to be married I am married I am married, but separated from my spouse I am divorced and have not remarried I am widowed and have not remarried I am in a relationship and wish to get married in the Catholic Church * Yes No I am cohabitating with a partner/significant other * Yes No Fiance’s Name * Fiance's Name First & Middle Names First & Middle Names Last Name Last Name Has your fiance ever been baptized/received into the Catholic Church? * Yes No Your fiance’s current religious affiliation (if any) * Is this your first marriage? * Yes No If this is not your first marriage, please indicate the number of prior marriages * Please indicate how each of those marriages were resolved (death, divorce and/or annullment) * Is this your fiance’s first marriage? * Yes No If this is not your fiance’s first marriage, please indicate the number of prior marriages * Please indicate how each of those marriages were resolved (death, divorce and/or annullment) * Spouse’s Name * Spouse's Name First & Middle Names First & Middle Names Last Name Last Name Was your spouse ever baptized/received into the Catholic Church? * No Yes, prior to our marriage Yes, after we got married Your spouse’s current religious affiliation (if any) * Date of marriage * Name of place of marriage * Name of church & denomination, courhouse, etc Location of marriage * City & state (and country if not the US) Is this your spouse’s first marriage? * Yes No If this is not your spouse’s first marriage, please indicate the number of prior marriages * Please indicate how each of those marriages were resolved (death, divorce and/or annullment) * Former Spouse’s Name * Former Spouse's Name First & Middle Names First & Middle Names Last Name Last Name Was your former spouse ever baptized/received into the Catholic Church? * No Yes, prior to our marriage Yes, after we got married Was this your first marriage? * Yes No If this was not your first marriage, please indicate the number of prior marriages * Please indicate how each of those marriages were resolved (death, divorce and/or annullment) * Was this your former spouse’s first marriage? * Yes No If this was not your former spouse’s first marriage, please indicate the number of prior marriages * Please indicate how each of those marriages were resolved (death, divorce and/or annullment) * Children Please list the names, ages, and relationship (i.e. son, daughter, step-son, step-daughter, et.c) for your children * Tye N/A if not applicable General Questions Please describe your own religious education or church background * How have you come to be interested in the Roman Catholic Church? * Do you have any questions that you would like to be answered at this time? * Submit If you are human, leave this field blank. Δ