RCIA Registration | Springbank Catholic

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RCIA Inquiry Form

Personal Information

First Name

Last Name

Maiden Name (if applicable)

Birthday * required

Place of Birth

Name of Mother

Name of Father

Contact Information

Mailing Address

Primary Phone

Secondary Phone

Email

Occupation

Religious Information

What, if any, is your current religious affiliation?

Have you ever been baptized? *

Yes

No

Other

In what denomination were you baptized?

Approximate date/age of baptism

Baptismal name (if different from current name)

Place of baptism (name of curch/denomination)

Mailing address of baptismal location

If you were baptized in the Catholic church, check those sacraments which you have already received

Penance (Confession)

Eucharist (First Communion)

Confirmation

Current Marital Status

I have 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 a widow/widower and have not remarried since my spouse's death

Other

Your fiance's name

Your fiance's religious affiliation (if any)

Is this your fiance's first marriage?

Yes

No

Is this your first marriage?

Yes

No

Your spouse's name

Your spouse's current religious affiliation (if any)

Is this your spouse's first marriage?

Yes

No

Date of marrriage

Place of marriage

Officiating authority of marriage

Family Information

Please list the names of your children or other dependents

Sponsor's full name

Thank you for your submission!

Springbank Catholic Family of Parishes | 519-471-4220

Springbank Catholic Office Hours:

Tues - Fri: 8:30AM-4:30PM

*Closed from 12PM-1PM

Serving St. John the Divine and St. George's Parishes, the office is located at St. George's Parish

ST. GEORGE

1164 Commissioners Rd. W

London, ON

N6K 1C7

ST. JOHN THE DIVINE

390 Base Line Rd. W

London, ON

N6J 1W1

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