Name * First Name Last Name Preferred Name Address * Suburb and Postcode * Phone * (###) ### #### Email * Date of Birth * Please write date as - Month : Day : Year MM DD YYYY Place of Birth SACRAMENTS RECEIVED * Have you already been Baptised, Confirmed or received your first Eucharist in another Church? (Please Tick) YES NO If you answered yes, please indicate which sacraments you have received. Baptism Confirmation Eucharist (Communion) Which best describes your current thoughts about celebrating full initiation in the Catholic Church I definitely want to become Catholic I think I might want to become Catholic I am 'just looking' - not sure at this time At present, I don't want to join the Catholic Church, but I am interested in understanding what Catholics believe YOUR FAITH JOURNEY Is there anything you would like to tell us about your faith journey to this point in your life? For example: When did you first become interested in the Catholic Church? Do you know anyone here at St Bernard's Belmont? What has led you to enquire about RCIA? What are you looking for, through a closer look at the Catholic Church? I give permission for my family's details to be added to St Bernard's Parish records Yes No PRIVACY St Bernard’s Parish is committed to maintaining your privacy in relation to the gathering, recording, storing and disclosure of information for the Church operations and to the provision of religious and pastoral care services. We will not disclose your personal information to other third parties without your consent. Thank you for registering your interest. A member of the RCIA Team will contact you shortly.