Clone of RCIA - St. Peter Chanel Catholic Church

St. Peter Chanel Catholic Church
Adults Becoming Catholic/Receiving Sacraments - RCIA
Welcome!. Please complete this form and "Submit" when you are done. The form will automatically be forwarded to us. Contact Margaret O'Grady, RCIA Coordinator if you have questions.

mogrady@stpeterchanel.org or 678-832-1232
Your Personal Identifying Information:
First Name:
Middle Name:
Last Name:
Street Address:
City:
ZIP:
E-mail*
Home Phone Number

Area CodePhone Number
Cell Phone Number*

Area CodePhone Number
Office Phone Number

Area CodePhone Number
Birth Date:
Birth City:
Birth State:
Your Family Information
Father's Name (First, Middle and Last):
Father's Religion:
Mother's Name: (First, Middle and Last):
Mother's Relgion
Spouse's Name (First, Middle and Last):
Spouse's Religion:
Children's Names and Ages:
Your Sacramental Information:
Were you baptized?:

YesNo
Which of the following Catholic Sacraments have you received?:

BaptismFirst Holy CommunionFirst ReconciliationConfirmation
Your Current Church Affiliation:
Name of the Church you Currently Attend:
Do you attend St. Peter Chanel?

YesNo
Are you registered at St. Peter Chanel?

YesNo
Your Current Marital Information (please check all that apply):

Never MarriedMarriedEngagedSeparatedDivorcedWidowed
Should be Empty: