Inquirer Information Form

Name*

First Middle Last

Maiden Name (if not applicable, enter n/a)*

Date of Birth*

Place of Birth (City, State, Country, if not USA)*

I. Contact Information

Address*

Mailing Address Apt City State Zip

Phone (Daytime)

Phone (Evening/Weekend)

Cell Phone*

Occupation

E-mail (Home)*

E-mail (Other)

II. Religious History

What, if any, is your present religious affiliation?*

Have you ever been baptized?*

Yes

I am not sure

please provide the following information:

(a) In what denomination were you baptized?*

(b) Date or your approximate age when you were baptized:*

(d) Address, if known:*

(e) City and State, if known; Country, if not USA:*

If you were baptized as a Catholic, check those sacraments you have already received:

Penance (Confession)

Eucharist (First Communion)

Confirmation

III. Current Marital Status

Check the appropriate statement below and provide any information requested beneath the statement.*

I am single and I have never been married.

I am engaged to be married.

I am married.

I am married, but separated from my spouse.

I am divorced and I have not remarried.

I am a widow/widower.

(a) Your Fiancé(e)'s Name:*

(b) Your Fiancé(e)'s Current Religious Affiliation (if any):*

This is my first marriage.

I have been married before.

(d) For your fiancé(e):*

This is his/her first marriage.

My fiancé(e) has been married before.

(a) Your Spouse's Name:*

(b) Your Spouse's Current Religious Affiliation (if any):*

This is my first marriage.

I have been married before.

(d) For your spouse:*

This is my spouse's first marriage.

My spouse has been married before.

(e) Date of Marriage*

(f) Place of Marriage:*

IV. Family Information

List the name(s) of any children or other dependents. Click the button below to add children/dependents

Relationship	Name	Age	Actions

There are no children/dependents.

(e.g. Daughter-Jane; Stepson-John.)

I. Contact Information

II. Religious History

III. Current Marital Status

IV. Family Information

Contact Information

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