RCIA Registration

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Name *

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Phone Number *

Email *

Date of Birth *

Place of Birth *

Father's Name *

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Last

Mother's Name (USE MAIDEN NAME) *

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Last

Baptism Status *

I am unbaptized and I am seeking baptism I am a validly baptized Christian and I desire to be received into the Catholic Church I am a baptized Catholic and I am seeking Confirmation Unknown

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RCIA Registration

1850 Emerald streeteugene, oregon 97403​541-343-7021﻿(map)﻿

1850 Emerald street
eugene, oregon 97403
541-343-7021
(map)