RCIA Interest Inquiry

Full Name

Date

First Name Preference

Maiden Name

Address

City

Zip

Home Phone

Cell Phone

Best time to call

Date of Birth

Email Address

Do you check daily?

Yes

Place of Employment

Have you been raised in any church and/or attended any church regularly?

Yes

If Yes, what denomination?

What is your current Marital Satus?

Never Married

Catholic Marriage

Other Christian Marriage

Civil Marriage

Divorced

If married, is this a first marriage for both you and your spouse?

Yes

Which one of these statements best describes your interest in participating in RCIA:

I know I want to become Catholic.

I think I want to become Catholic but still have some questions or doubts.

I am not interested in becoming Catholic at this time.

Do you have any children who are interested in becoming Catholic?

*Yes

*If yes, please list names and ages.

Thank you for your interest in the St. Jude RCIA program. We will contact you soon.

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2130 Pemberton Dr, Fort Wayne, IN, 46805, United States

Msgr. Robert Schulte: 260-484-6609 ext 1001

rschulte@stjudefw.org

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