Our Lady of Perpetual Help Church | Reg. Adult RCIA 2024-2025

Name *

First

Middle

Last

Maiden Name

Address *

Address Line 1

City

State

Zip Code

Cell Phone *

Email *

Date of Birth *

Gender *

Marital Status *

Married

Are you a Parishioner at OLPH? *

If you answered no, what Parish do you attend?

Baptismal Certificate

Please upload Baptismal certificate

Date of Baptism

Church of Baptism

Church of Baptism Address

Address Line 1

City

State

Zip Code

First Communion Certificate

Please upload First Communion Certificate

Date of 1st Communion

Church of 1st Communion

City of 1st Communion

Father name *

(first and last) per baptismal certificate

Mother Name *

(first, maiden and last name) per baptismal certificate

Adult Confirmation Registration *

Price: $ 200.00

Total

$ 0.00