OCIA Intake Form

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Email REQUIRED Please fill out this field. Please enter an email address.

Phone Number REQUIRED

Please fill out this field. Please enter a phone number.

Place of Birth (City, State, Country) REQUIRED Please fill out this field. Please enter valid data.

Date of Birth REQUIRED Please fill out this field. Please enter a date.

Current Age REQUIRED Please fill out this field. Please enter valid data.

Mailing Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Occupation REQUIRED Please fill out this field. Please enter valid data.

What, if any, is your present religious affiliation? REQUIRED Please fill out this field. Please enter valid data.

Have you ever been baptized? REQUIRED Yes No Unsure Please fill out this field.

If you were baptized Catholic, please select ALL Sacraments below that you have already recevied: Penance (Reconciliation/Confession) Eucharist (First Holy Communion) Confirmation

Currnet Marital Status: (Please select ALL that apply) REQUIRED Never Married Engaged to be Married Married, but separated from my spouse Divorced and have not remarried Widow/Widower and I have not remarried Please fill out this field.

SECTION FOR CANDIDATE WHO IS ENGAGED TO BE MARRIED

If you are Engaged, you MUST complete this section!

Fill if Engaged to be Married (Select 1) Please fill out this field.
Engagement 1
- Fiance's Full Name REQUIRED Please fill out this field. Please enter valid data.
- Fiance's Current Religion Affiliation REQUIRED Please fill out this field. Please enter valid data.
- Please select the appropriate choice for YOURSELF (not your fiance)
- Please select the appropriate choice for your Fiance REQUIRED Please fill out this field.

SECTION FOR CANDIDATE WHO IS MARRIED

If you are married, you MUST complete this section!

Fill if Married (Select 1) Please fill out this field.
Marriage 1
- Spouse's Full Name REQUIRED Please fill out this field. Please enter valid data.
- Spouse's Religious Affiliation (if any) REQUIRED Please fill out this field. Please enter valid data.
- Please Select the appropriate choice for YOURSELF (not your spouse) REQUIRED Please fill out this field.
- Please Select the appropriate choice for your spouse REQUIRED Please fill out this field.

Please select the appropriate choice for YOURSELF (not your Spouse) This is my first marriage I have been married before

Please select the appropriate choice for your Spouse: This is his/her first marriage He/She has been married before

Date of Marriage REQUIRED Please fill out this field. Please enter a date.

Place of Marriage (City, State, Country) Please enter valid data.

Who was the officiating authority of your marriage? Civil Government Non-Christian Minister Christian Minister Catholic Clergy Other

MAC Pastorate consists of 2 Parishes - Which Parish would you like to call home? REQUIRED Please fill out this field.

Please provide any additional information that you believe may be important for our OCIA team to know.

Email REQUIRED Please fill out this field. Please enter an email address.

ST. MICHAEL THE ARCHANGEL

Baltimore, MD

OCIA Intake Form

SECTION FOR CANDIDATE WHO IS ENGAGED TO BE MARRIED

SECTION FOR CANDIDATE WHO IS MARRIED