Adult Inquirer Information Form

St. Thomas Aquinas Catholic Church

Information on this form is held in confidence and is not shared without your permission

Today’s Date: ______

Name: First: ______Middle: ______Last: ______

Maiden Name (if applicable): ______

Date of Birth: ______Age: ______

Place of Birth: ______

(include locality (town, city, county, etc.) region (state, province, territory, etc.) and country)

Name of Father: ______

Name of Mother: ______

I. CONTACT INFORMATION

Full Mailing Address: ______

Phone: (Daytime) ______(Evening/Weekend) ______

Cell Phone: ______Occupation: ______

Email: (Home) ______(Other) ______

II. RELIGIOUS HISTORY

1. What, if any, is your present religious affiliation? ______

2. Have you ever been baptized? ______Yes______No ______I am not sure

If you answered “Yes to Question 2, please provide the following information:

a)In what denomination were you baptized? ______

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

c)Baptism name (if different from current name): ______

d)Place of Baptism (name of church/denomination): ______

e)Address, if known: ______

f)Location, if known: ______

(include locality (town, city, county, etc.) region (state, province, territory, etc.), and country)

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

____ Penance (Confession)____ Eucharist (First Communion____ Confirmation

CURRENT MARTIAL STATUS

Check if appropriate statement (s) below and provide any information requested beneath each statement.

____ 1. I have never been married.

____2. I am engaged to be married

a) Your Fiancé’s Name: ______

b) Your Fiancé’s Current Religious Affiliation (if any): ______

c) For you: ____ This is my first marriage. ____ I have been married before.

d) For your fiancé: ____ This is his/her first marriage. ____ My fiancé has been married before.

____3. I am married

a)Your Spouse’s Name: ______

b)Your Souse’s Current Religious Affiliation (if any): ______

c)For you: ____ 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: ______

(include locality (town, city, county, etc.) region (state, province, territory, etc.) and country)

g) Officiating Authority of Marriage: ______

(civil government, non-Christian minister, Christian minister, Catholic cleric)

____ 4. I am married, but separated from my spouse.

____ 5. I am divorced and I have not remarried.

____ 6. I am a widow/widower and have not remarried since my spouse’s death.

IV. FAMILY INFORMATION

List the name (s) of any children or other dependents (e.g., Daughter – Jane: Stepson – John).

Relationship: ______Name: ______Age: ______

V. GENERAL QUESTIONS

1. What or who has led you to want to know more about the Catholic Faith?

______

2. Please describe the types of religious education you have received, as a child and as an adult.

______

3. What contact have you had with the Catholic Church to date?

______

4. What are some of the questions or concerns you have about the Catholic Church?

______

5. At this point in time, which of the following statements best describes your present feelings and thoughts about the

possibility of joining the Catholic Church? (please circle one)

A. I need much more information about the Catholic Church before I would consider joining.

B. I am considering joining, but I am still unsure about it.

C. I am fairly sure that I would like to join, but I still need some time to study and pray about it.

D. I am fairly sure that I want to join the Catholic Church.

Información de adultos

Iglesia Católica St. Thomas Aquinas

La información de esta forma en confidencial y no la compartiremos con nadie sin su permiso.

Fecha de hoy: ______

Nombre: Primero: ______Medio: ______Apellido: ______

Nombre de soltera (si aplicable): ______

Fecha de Nacimiento: ______Edad: ______

Lugar de nacimiento: ______

(Incluye local (pueblo, ciudad, condado, etc.) región (Estado, provincia, territorio, etc.) y país)

Nombre del padre: ______

Nombre de la madre: ______

I. Información para contacto

Dirección para correo: ______

Teléfono: (diurno) ______(noches/fines de semana) ______

Teléfono celular: ______Ocupación: ______

Correo electrónico: (casa) ______(Otro) ______

II. Historian Religiosa

1. ¿Cuál, si hay, es su presente afiliación religiosa? ______

2. ¿Ha sido bautizado? ______Sí ______No ______No estoy seguro

Si la respuesta de la pregunta 2 es “sí”, por favor proporcione las informaciones siguientes:

a)¿En cuál denominación fue usted bautizado? ______

b)Fecha o fecha aproximada de su bautismo: ______

c)Nombre de pila (si diferente de su nombre actual): ______

d)Lugar de bautismo(nombre de la iglesia/denominación): ______

e)Dirección, si lo sabe: ______

f)Local, si lo sabe: ______

(Incluye local (pueblo, ciudad, condado, etc.) región (Estado, provincia, territorio, etc.) y país)

3. Si usted fue bautizado como católico, cuales los otros sacramentos que ha recibido

_____ Reconciliación (Confesión) _____ Eucaristía (Primera Comunión) _____ Confirmación

Estado matrimonial actual

Marque e solo las oraciones abajo que son apropiada s y proporcione cualquiera información requerida en la línea abajo.

____1. Nunca estuve casado/a.

____ 2. Estoy comprometido/a a casamiento.

a)Nombre de novio/a: ______

b)La afiliación actual de su novio/a (si hay alguna): ______

c)Para usted: ____ Este es mi primer matrimonio. ____ Estuve casado/a antes.

d)Para su novio/a: ____ Este es su primer matrimonio. ____ Mi novio/a ya estuvo casado/a antes.

____ 3. Estoy casado/a

a)Nombre de su esposo/a: ______

b)Actual afiliación religiosa de su esposo/a (si hay alguna): ______

c)Para usted: ____ Este es mi primer matrimonio. ____ Estuve casado/a antes.

d)Para su esposo/a: ____ Este es su primer matrimonio.____ Mi esposo/a ya estuvo casado/a antes.

e)Fecha del matrimonio: ______

f)Lugar del matrimonio: ______

(Incluye local (pueblo, ciudad, condado, etc.) región (Estado, provincia, territorio, etc.) y país)

g)Autoridad oficial del matrimonio: ______

(Goberno civil, ministro no cristiano, ministro cristiano, cura católico)

____ 4. Estoy casado/a, pero separado/a de mi esposo/a.

____ 5. Estoy divorciado/a y no he casado nuevamente.

____ 6. Soy viudo/a y no he casado nuevamente.

IV. Información de Familia

Lista de nombres de hijo/hija

Nombre: ______Relación: ______Edad: ______

V. GENERAL QUESTIONS

1. What or who has led you to want to know more about the Catholic Faith?

______

2. Please describe the types of religious education you have received, as a child and as an adult.

______

3. What contact have you had with the Catholic Church to date?

______

4. What are some of the questions or concerns you have about the Catholic Church?

______

5. At this point in time, which of the following statements best describes your present feelings and thoughts about the

possibility of joining the Catholic Church? (please circle one)

A. I need much more information about the Catholic Church before I would consider joining.

B. I am considering joining, but I am still unsure about it.

C. I am fairly sure that I would like to join, but I still need some time to study and pray about it.

D. I am fairly sure that I want to join the Catholic Church.