St. Jane Frances de Chantal
Catholic Church
(Pastorate parish with OLC)

8499 Virginia Ave.
Riviera Beach, Maryland 21122

www.stjane.org

www.stjane.org

Facebook Flocknote Phone

RCIA Registration

- Give

RCIA Registration Form 2021-22
The maximum number of form submissions has been reached. This form is currently not available.
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  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 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.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Mother's Maiden Name: REQUIRED Please fill out this field. Please enter valid data.
- Sacraments Recieved: REQUIRED Baptism 1st Eucharist Confirmation None Please fill out this field.
- If Baptized, Church of Baptism: Please enter valid data.
- Denomination: Please enter valid data.
- Names of Godparents: Please enter valid data.
- Church of Baptism Address: Please enter valid data.
- Date of Baptism: Please enter valid data.
- If you received First Eucharist, Church of Eucharist: Please enter valid data.
- Church of First Eucharist Address: Please enter valid data.
- Date of First Eucharist: Please enter valid data.
- Marriage Information (if applicable)
- Name of Spouse: Please enter valid data.
- Place of Marriage: Please enter valid data.
- Is this your first marriage: Please enter valid data.
- Civil or Church Ceremony: Please enter valid data.
- Is this the first marriage for your spouse: Please enter valid data.
- RCIA Sponsor (if you do not have one at the time of registering, just leave the following boxes blank)
- Sponsor Name: Please enter valid data.
- Phone Number: Please enter valid data.
- Email: Please enter valid data.
Submit

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.