Inclusion Registration Form

Name*

First Name Last Name

Email*

Phone Number*

Address*

Street City State ZIP

Date of Birth*

Marriage and Family

Marriage Status*

If remarried, how many times?

Spouse's Name

Spouse's Religion

Has your spouse been previously married?

How many times?

Where you married by a priest or a deacon?

If married by a priest or deacon, then by whom?

Date of wedding

Children (if no children, then just skip this section)

#1 Child's Name

Child's Religion

Birth Date

#2 Child's Name

Child's Religion

Birth Date

#3 Child's Name

Child's Religion

Birth Date

Faith and Religious Background

Have you been Baptized?*

If "yes", in what denomination?

Were you raised in a Christian Family?*

What is bringing you to the Catholic Church?*

Mass Times