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RCIA Registration

Catechumenate (Instruction in the Faith)

Thanks for taking a moment to register your information with Brother Larry Lussier's office. Please fill out the form as completely as possible and then click submit.

Personal Information
Name
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Name of person applying for RCIA.
Name of Spouse if this applies
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Natural Father's name and Natural Mother's name and maiden name.
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First and Last Names of Child(ren) in Household
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Primary Phone --
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Secondary Phone --
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Email Address
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Alternative Email Address
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Home Address
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Birth Date
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month day year without a slash between (just numbers)
City and State of Birth
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Sacramental Status
Fill in if Baptized or made 1st Communion
Church of Baptism
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If baptized list name of Church
City, State where Baptized
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Church of 1st Communion
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If this applies, please fill in.
City, State where !st Communion happened.
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Personal Status
Single Married Separated Divorced Have an Annulment Divorced and remarried This is my first marriage This is my spouse's first marriage This is my spouse's second marriage
Status
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Choose the correct status.
Status
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