Inquirer Information Form - Adult

"*" indicates required fields

Adult Inquirer Information Form

Information is held in confidence and is not shared without your permission.
Adult's Name*
(If Applicable)
Date of Birth*

I. Contact Information

Full Mailing Address
Daytime
Evening/Weekend
Cell/Mobile
Other

II. RELIGIOUS HISTORY

1. Has you ever been baptized?
2. If you were baptized as a Catholic, check those sacraments you have already received

If you answered “Yes” to Question 1, please provide the following information:
(include locality (town, city, county, etc.), region (state, province, territory, etc.), and country)

III. CURRENT MARITAL STATUS

Check the appropriate statement(s) below and provide any information requested beneath each statement.
1. I have never been married.
2. I am engaged to be married.
2.(c) For you
3.(d) For your fiancé(e):
3. I am married.
3.(c) For you
3.(d) For your spouse:
MM slash DD slash YYYY
(include locality (town, city, county, etc.), region (state, province, territory, etc.), and country)
(civil government, non-Christian minister, Christian minister, Catholic cleric)
4. I am married, but separated from my spouse.
5. I am divorced and I have not remarried.
6. I am a widow/widower and have not remarried since my spouse’s death.

IV. FAMILY INFORMATION

List the name(s) of any children or other dependents (e.g., Daughter — Jane; Stepson — John).

VI. GENERAL QUESTIONS

5. At this point in time, which of the following statements best describes your present feelings and thoughts about the possibility of joining the Catholic Church? (please circle one)