RCIA Sign Up

Fill out the form Below and Brittany Brown will be in contact with you soon! You can also send an email to rcialourdes@gmail.com with any questions you may have. 

RCIA Program *
Personal Information
Name *
Name
Address *
Address
Phone *
Phone
Date of Birth *
Date of Birth
Gender *
If you're not in school, put NA.
City, State
Father's Name *
Father's Name
Mother's Name *
Mother's Name
Emergency Contact Information
Emergency Contact Name *
Emergency Contact Name
Phone *
Phone
Marital Information
Marital Status *
Are you currently living with a significant other while not being married? *
Are you currently planning to get married? *
If you are married, were you married in the Catholic Church? *
If you are NOT married, please select NA
If no, select one. *
If you are NOT married, select NA.
Is your spouse baptized Catholic? *
If you are NOT married, select NA.
Have you ever been divorced? *
Has your spouse ever been divorced? *
If you are NOT married, select NA.
Sacraments
Have you been baptized? *
Have you been Confirmed? *
Have you received First Holy Communion in the Catholic Church? *
Please answer the following questions...