St. Ignatius Martyr Catholic Church

First, Middle, and Last Name REQUIRED Please fill out this field. Please enter valid data.

Street Address: REQUIRED Please fill out this field. Please enter valid data.

City & State: REQUIRED Please fill out this field. Please enter valid data.

Zip Code: REQUIRED Please fill out this field. Please enter valid data.

Best phone number: REQUIRED Please fill out this field. Please enter valid data.

Alternate phone number Please enter valid data.

Email Address: REQUIRED Please fill out this field. Please enter valid data.

Birth Date: REQUIRED Please fill out this field. Please enter valid data.

Birth City & State: REQUIRED Please fill out this field. Please enter valid data.

Birth Country: REQUIRED Please fill out this field. Please enter valid data.

Baptism Date: REQUIRED Please fill out this field. Please enter valid data.

Baptism Church: REQUIRED Please fill out this field. Please enter valid data.

Baptism City & State: REQUIRED Please fill out this field. Please enter valid data.

First Communion Date (if received) Please enter valid data.

First Communion Church (if received) Please enter valid data.

Father's First, Middle, and Last Name: REQUIRED Please fill out this field. Please enter valid data.

Mother's Maiden Name: REQUIRED Please fill out this field. Please enter valid data.

At what parish do you usually attend Mass? REQUIRED Please fill out this field. Please enter valid data.

What sacraments do you wish to receive? REQUIRED Confirmation First Eucharist (Communion) First Reconciliation (Confession) Please fill out this field.

If SINGLE, have you ever been married? REQUIRED Yes No Not applicable Please fill out this field.

Are you living with someone as if you were married? REQUIRED Yes No Not applicable Please fill out this field.

Are you planning on getting married in the near future? REQUIRED Yes No Please fill out this field.

Are you currently married? REQUIRED Yes No Please fill out this field.

If YES, what date were you married? Please enter valid data.

If YES, did this marriage take place in the Catholic Church? Yes No

If not in the Catholic Church, was it a civil ceremony? Yes No

If not in the Catholic Church, was it in another church? Yes No

If YES, what was the name of the Church? Please enter valid data.

City & state of the church? Please enter valid data.

If MARRIED, have you been married more than once? REQUIRED Yes No Not applicable Please fill out this field.

If YES, please explain in detail:

If DIVORCED, have annulments been granted? REQUIRED Yes No Not applicable Please fill out this field.

Has your spouse/fiance ever been married? REQUIRED Yes No Not applicable Please fill out this field.

If YES, were annulments granted? Yes No

If you are seeking Confirmation and/or Eucharist, why do you wish to receive these sacraments? REQUIRED Please fill out this field.

What is your recent experience of "church" (for example, attend Mass, religious education, youth group, retreats, bible study, etc.?) REQUIRED Please fill out this field.

What was your religious education as a child? REQUIRED Please fill out this field.

What has been your religious education as an adult? REQUIRED Please fill out this field.

What was your family experience of "church" (for example, attend Mass, pray together, religious symbols in the home, etc.?) REQUIRED Please fill out this field.

Would you like to take the preparation class in English (on Tuesday evenings) or Spanish (Monday evenings)? // ¿Le gustaría asistir a clases en español (los lunes por la noche) o en inglés (los martes por la noche)? REQUIRED Please fill out this field.

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