Inquiry Form (This is not an application)
General Information
Name and Age	First Name: Last Name:	M.I.: Date of Birth:
Contact Info.	Email:         Phone (H):  Phone (W):
Current Address	Street: City:    State:   Alabama Alaska Arizona Arkansas California Colorado Conneticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip:
Permanent Address (If other than current address)	Street: City:    State:   Alabama Alaska Arizona Arkansas California Colorado Conneticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip:
Religion	Are you a Roman Catholic? Yes No Present Parish: Present Pastor:
Parents (Father)	Name: Living? Yes No      Year of Death:	Religion:
Parents (Mother)	Name: Living? Yes No      Year of Death:	Religion:
Parents	Parent's Marital Status:
Family	Number of Sisters:  Number of Bothers:	Rank in Family:
Commitments	Have you ever been married? Yes No Are you responsible for the financial support of any other person? Yes No	Do you have any children? Yes No Are you involved in any lawsuits or other legal proceeding Yes No
Crime	Have you ever been arrested or charged with a crime? Yes No If yes, please explain:
Health
General	Height:    Eyesight: Good Medium Poor Weight:   Hearing:  Good Medium Poor	Do you smoke? Yes No Is your health as good as most people? Yes No
Infirmities	Specify any physical or psychological infirmities:
Addictions	Specify any past or present addictions:
Education
Name of School Final Level Date of Completion Age at Completion Degree Obtained Elementary Yes No High School Yes No College Grad. School Other
Prior Religious Affiliations	Have you ever studied for a diocese, or been a candidate for a religious community? Yes No If yes, please specify where and when:
All information contained in this form is kept confidential.