Our Lady Help of Christians 
R.C.IA. 
(Rite of Christian Initiation) 
Registration Form 

NAME 	_ 

STREET ADDRESS 	_ 

CITY, STATE, ZIP CODE 	_ 

E-MAIL ADDRESS 	_ 

HOME TELEPHONE 	CELL 	_ 

WORK TELEPHONE 	_ 

I AM: 	Baptized (Denomination) 	

	Baptized Catholic 	 

Not Baptized        ____________________________

I AM: 	Single 	
	Married, __________
	Married by a 	____________________ 
Divorced __________

I would like to find out more information about the Catholic Faith. _________________________

I am a Catholic and would like to receive the Sacrament of Confirmation. ______________________ 

I have questions and would like someone to call me. ______________________