-RCIA Registration

Saint Mary Catholic Church – RCIA Registration
8343 Woolmarket Road, Biloxi, MS 39532
228-392-1999 (Office) 228-392-4552 (Fax)

First Name REQUIRED Please fill out this field. Please enter valid data.

Middle Name Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Maiden Name (if applicable) Please enter valid data.

Street Address Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Home Phone: Please enter valid data.

Cell Phone: Please enter valid data.

Work Phone: Please enter valid data.

Email Please enter an email address.

Birth Information

City Maximum 60 characters Please enter valid data.
State Maximum 50 characters Please enter valid data.
Date of Birth Maximum 24 characters Please enter valid data.
Father's Name (include middle name) Please enter valid data.
Mother's Name (include middle name and maiden name) Please enter valid data.

Religious Background

Marriage

If any other family members are currently in the RCIA process, please provide their names: Please enter valid data.

Do you have someone in mind to be your sponsor (a practicing Catholic who has received the Sacrament of Confirmation and will support you and join you for sessions and rites)? Yes No

If Yes, Sponsor's Name (include middle name) Please enter valid data.

Check any that apply to you: I have questions about the teachings of the Catholic Church I am fairly certain I want to join the Catholic Church I am a Catholic seeking the Sacrament of Confirmation