St. Rose Priory Church

For Office Use Only:

Baptismal Proof ___  Sponsor/godparents_________________________
Letter Received

Confirmation Name: _______________________

Sacraments conferred/date: _________________________________________

_________________________________________

Priest:

SAINT ROSE &
HOLY ROSARY
CATHOLIC CHURCH

OCIA Sacramental Record Form

Date: _______________________________

Name: First:_______________________Middle:_____________________Last:_________________________________

Maiden Name (if applicable):___________________________________________________________________

Date of Birth:_________________________ Place of Birth:_________________________________________(Include [city, state, & country if not USA)

Full Name of Father (First, Middle, Last): _________________________________________________________

Full Name of Mother (First, Middle, include Maiden Name): _______________________________________

I. CONTACT INFORMATION

Full Mailing Address:__________________________________________________________________________

_____________________________________________________________________________________________

Phone: _________________________________ Email: ____________________________________________

II. RELIGIOUS HISTORY

Have you ever been baptized? Yes___ No___ I am not sure___

If you were baptized in a non-Catholic Church:

1. In what denomination were you baptized? _________________________________________

2. Place of Baptism (name of church/denomination): _________________________________

3. Address:___________________________________________________________________

   ___________________________________________________________________

 

4. Date or approximate age when you were baptized:____________________________

5. Baptismal name (if different from current name): ____________________________________

If you are a baptized Catholic:

6. Church of Baptism:______________________________________________________________

7. Address:_______________________________________________________________________

   _______________________________________________________________________

8. Date or approximate date of baptism? ______________________________________________

9. Baptismal name (if different from current name): ____________________________________

Marital Status:

Single _____ Engaged _______ Married ______ Widowed _______

Have you or your spouse ever been divorced _________

If married or divorced:

• • I have spoken with the priest supervising OCIA about my marriage and supplied him with the necessary documents requested.

III. GODPARENTS / SPONSORS

Full Name of Godparent/Sponsor: (First, Middle, Last) __________________________________________

Relationship to Godparent(s)/Sponsor:_________________________________________________________

My sponsor is registered at the following parish: ________________________________________________

IV. Parish Registration

Please complete one of the following:

• • I would like to register at St. Rose as a parishioner. ______

• • • Please send me contribution envelopes

• • I will register at another parish immediately following my reception into the Church.
    Name of parish __________________________________