OCIA Inquiry Intake Form

Date:

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Personal Information (Please include full legal name and maiden name below if applicable.)

Name

Maiden Name (if applicable)

Preferred Name/Nickname

Date of Birth

Age

Occupation/Place of Employment

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Contact Information

Home Address

City

State

Zip

Primary Phone

Is your primary phone number

Home

Cell

Work

Email

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Personal History

Place of Birth

Mother's Full Maiden Name

Father's Full Name

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Religious Background

Do you have a current religious affiliation?

Yes

No

If yes, what is it?

Are you baptized?

Yes

No

Unsure

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If yes,

What denomination?

Approximate date

Have you received any additional sacraments?

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Family and Life Situation

These questions are intended to examine each person's situation in order to best accompany catechumens and candidates.

Current Marital Status

If other, please explain

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If engaged/married

Spouse/Fiancé(e)'s Name

Spouse/Fiancé(e)'s Religious Background (if any)

Date of Marriage (if applicable)

Place of Marriage (if applicable)

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If married

Who officiated your wedding? (Christian or Catholic pastor, civil authority, or non-Christian minister)

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Dependents

Do you have children or dependents?

Yes

No

List names and ages, if you wish to share.

Living Situation (check all that apply)

Living alone

Living with spouse

Living with fiance(e)

Living with children

Living with parents/family

Living with others

If living with others, please describe)

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Journey of Faith

At this point, how would you describe your interest in the Catholic Church and intention to join the OCIA process?

I am curious but am not ready to make a commitment.

I want to learn more and am open to

I desire to become Catholic, though I know I need more time to study and pray

I am confident that God is calling me to join the Catholic Church.