OCIA FORM PAGE

OCIA Questionnaire

Name

First Last

Maiden Name (if applicable)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone Number

Cell Phone

Date of Birth

Father's Name

First Last

Father's Religion

Mother's Name

First Last

Mother's Religion

Occupation

Workplace

Presen Marital Status

Married

Single

*Engaged

Separated

Divorced

*If engaged: planned date for the wedding?

Planned church for the wedding

**If you have been married outside of a Catholic church or if you are divorced, please speak to the Facilitator of the OCIA process

Have you previously been married in church, civilly, or in common law?

Anything we should know?

*Have you been baptized? If yes, please let us know what denomination

Why are you interested in OCIA?