(Rev. 3/31/2017)

Office of Initial Diaconate Formation

Inquirer Intake Form

http://www.rcda.org/Offices/deacons/PDF/Intake%20Form.doc

Use Tab Key to Navigate. Instructions are on second page.

Part A: Contact Information

Date Completed:
Inquirer’s Name: / Last, First & Middle
Date of Birth: / mm/dd/yyyy / Place or Birth: / City, State or Country / US Citizen? / YES/NO
911 Address: / Street #, City, State & Zip
How long have you lived at this address? / # of years
Mailing Address: / If different from 911 address or N/A
Home Phone: / ac + # / Cell: / Work:
*Email Address: / Enter address or "None"

*You MUST obtain email access and computer prior to the formal discernment phase.

Part B: Additional Information

Marital Status: / “Single,” “Married,” “Divorced/Annulled,” “Seperated,” “Widow.”
Wife’s Name: / Enter N/A if single or wife’s full name.
Wife’s Faith Tradition: / Enter N/A if single or wife’s full name.
Names: / Dates of Birth:
None or Names of Children. / Enter "N/A or DOB's.
Children:
Parish: / Parish Name and City/Town/Village.
How Long at Parish? / #yrs / Years Catholic: / Enter years + Baptized infant or RCIA.
Pastor/Administrator/PLD: / Name and Title e.g. Rev. Patrick Butler, Pastor.
Ministry Formation Status:
FMP or Kateri / Completed, or 1st 2nd or 3rd yr, or “Not Started Yet.”
FMP or Kateri Completed? / Year Completed and/or Site or N/A.
Employment: / Employer's name & City, Unemployed, Retired or other.
Parish Ministry: / YES/NO / Describe: / If yes, describe ministries, or N/A.
Active in Community: / YES/NO / Describe: / If yes, describe or N/A.
Additional Comments: Optional.

Part C: Results of Intake Interview

For Office use only.

Instructions

1. Print this instruction and the Inquirer Intake Form.

2. Prior to completing the Inquirer Intake Form, carefully read the diocesan publication: “A Prayerful Guide for Discerning a Vocation to the Diaconate,” available on line at www.rcda.org. Click “Offices,” “Deacons,” and “New Vocations to the Diaconate.” The guide is available under “Discernment Guide.”

3. Pray frequently about your possible “call” to the ordained ministry of deacon.

4. When you are ready to begin the inquiry process, using a computer, complete Part A and Part B of the attached Inquirer Intake Form. E-mail the form as an attachment to . If you do not have access to a computer and/or email, you may call the Initial Diaconate Formation Office and we will complete the form for you by telephone. But remember, once formal discernment begins with the Discernment Retreat, all forms and documents must be completed via computer and you must use email for most correspondence.

5. When you are ready to schedule an appointment to meet with the Director of Initial Diaconate Formation as described in the discernment guide, call the Pastoral Associate for Initial Diaconate Formation at 518 453-6670. The Pastoral Associate will schedule an appointment.

6. If you have any questions, please call the office.

Roman Catholic Diocese of Albany

Office of Initial Diaconate Formation

40 North Main Avenue

Albany, New York 12203

518 453-6670