OCIA Teen Registration

Youth Information

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

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

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

Gender REQUIRED Male Female Please fill out this field.

Date of Birth REQUIRED Please fill out this field. Please enter valid data.

City, State, and Country of Birth REQUIRED Please fill out this field. Please enter valid data.

Current Grade Level REQUIRED Please fill out this field. Please enter valid data.

Primary Residence is with: REQUIRED Both Parents Both Parents, but in separate homes Mother Father Other Please fill out this field.

Is your teen attending Catholic Mass? REQUIRED Regularly Sometimes Never Please fill out this field.

If yes - at which parish? Please enter valid data.

Has your teen participated in Catholic faith formation? REQUIRED Yes No Please fill out this field.

If yes - how many years? Please enter valid data.

If yes - when? Please enter valid data.

If yes - where? Please enter valid data.

Is your family registered at Our Lady of Fatima Parish? REQUIRED Yes No Please fill out this field.

Parent/Guardian 1

First Name REQUIRED Please fill out this field. Please enter valid data.
Last Name REQUIRED Please fill out this field. Please enter valid data.
Relationship to teen you are registering REQUIRED Mother Father Other Please fill out this field.
Phone REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Email REQUIRED Please fill out this field. Please enter an email address.
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.
Religion REQUIRED Please fill out this field. Please enter valid data.

Parent/Guardian 2

Baptism

Reconciliation (Confession)

Has your teen received Catholic sacrament of Reconciliation? REQUIRED Yes No Please fill out this field.

Confirmation

Has your teen received Catholic sacrament of Confirmation? REQUIRED Yes No Please fill out this field.
Date of Confirmation Please enter valid data.
Church of Confirmation Please enter valid data.
City, State, and Country of Confirmation Please enter valid data.

First Eucharist

Has your teen received Catholic sacrament of First Eucharist? REQUIRED Yes No Please fill out this field.
Date of First Eucharist Please enter valid data.
Church of First Eucharist Please enter valid data.
City, State, and Country of First Eucharist Please enter valid data.