Registration Form for RCIA Candidate
In High School (11th and 12th Grades)
Catechism for Young & Adults / R.C.I.A
The rite of Christian initiation for adults (R.C.I.A.) is a religious education program for individuals 16 years of age or older that have not yet received any of the initiation sacraments: Baptism, Confirmation and/or Eucharist. It is also for adults from other faiths that are looking to become members of the Catholic community. Those who have been baptized Catholic, but have not received formal Catholic instruction are also welcome to be part of this program.
Catecismo para Jovenes y Adultos / R.I.C.A
El Rito de Iniciación Cristiana de Adultos (R.I.C.A.) es un programa de educación religiosa para jóvenes mayores de 16 años o adultos que no hayan recibido los sacramentos de iniciación: Bautismo, Comunión y/o Confirmación, o para adultos de otras tradiciones religiosas que desean investigar las posibilidades de convertirse en miembros de la comunidad católica. Los católicos bautizados que no han tenido un entrenamiento o preparación en la Iglesia también son bienvenidos a este programa. El R.I.C.A. forma adultos preparados en la sabiduría y tradición de la iglesia, ya que por medio de la oración y el estudio profundo de nuestra fe católica, desarrollan un entendimiento y amor esenciales para su formación espiritual.
Important Information
Coordinators: Mrs. Nini Fernadez, Ms. Silvia Muñoz, Mrs. Belinda Somoza,
Mrs. Norma Reinefeld & Mr. Michaell Martinez
E-Mail: ,
Phone: Office: 305-593-6123 / Emergency: 305-484-1568
Period of Formation:
Usually is only one school year of classes, starting September and ending May
Class hours: Mondays at Our Lady of Guadalupe parochial offices From 7.00 PM -- 8.30 PM
If you are not able to attend this schedule, please let us know to see how can we help you.
Cost: $ 100.00 (includes the books, material used during the formation year and gowns for the confirmation)
Documents to Submit:
A) Personal Information: See attached form.
B) Copy of your: 1- Birth Certificate
2- Baptism Certificate (if you are baptized) or Affidavit of Baptism (if you are not able to provide a copy of your Baptism Certificate) or Baptism Application Form (if you are not baptized)
3- First Communion Certificate or Affidavit of First Communion
(if you are not able to provide a copy of your First Communion Certificate)
C- Your Donation of $ 100.00
Personal Information
Information is held in confidence and is not shared without your permission
Today’s Date ____/____/______Parish # ______
Name: First ______Middle ______Last ______
Date of Birth: ______Male _____ Female ______
Address:______Apt. ______
City: ______State: ______Zip: ______
Place of Birth (City, State, Country if not USA)______
School grade he/she will be attending in 2015-2016 ______
Language preference for classes: English ______Spanish ______
Parents’ Information
Father’s Name ______Phone # ______
Mother’s Name ______Phone # ______
Father’s e-mail: ______
Mother’s e-mail: ______
(Please, check the best phone # and email for us to communicate with you)
Religious History
Has the candidate ever been baptized? ___ No ___ Yes. If yes, at what age: ______
In what denomination? Catholic? ___ Baptist? ___ Presbyterian?_____ Other Church?______
Place of Baptism (name of church/ denomination):______
Address (if known): ______
City and State; Country if not USA: ______
If baptized as a Catholic, check those sacraments you have already received:
____ Penance (Confession) ____ Eucharist (First Communion) ____ Confirmation
Collaboration Needed to run the RCIA Program
We need your collaboration to be able to run the RCIA Program.
With your collaboration we provide you with the Confirmation Gown,
and the Class Book among other catechetical materials.
Cost to run the RCIA: $ 100.00
1- Cash Option or Money Order: Total Amount: $ ______
2- Check Option Total Amount: $ ______Check # ______
3- Credit Card Option
Authorization for Our Lady of Guadalupe Churchto charge my credit card.
To Our Lady of Guadalupe Church
11402 NW 41st Street # 221, Doral, Florida 33178
Ph.: 305-593-6123 - Fax: 305-593-6130
E-mail: , Website: www.guadalupedoral.org
I ______
(name in credit card)
authorize Our Lady of Guadalupe Church to charge my credit card # ______
Type of Credit Card (circle one) Visa - Master Card - American Express
The total of $ ______ as collaboration for the year 2015-2016 RCIA program.
I would like to pay it in ______(# of payments) of $ ______(amount of each payment)
Credit Card Expiration date: ______
Billing Zip Code of Credit Card ______
______
Signature
The information you provide in this form will be destroyed after we charge your credit card, in order to protect your privacy.
Page# 3 | RCIA Registration Form for High School Students