Inquirer'S Interview/information Form printable pdf download

Inquirer'S Interview/information Form

INQUIRER’S INTERVIEW/INFORMATION FORM

(revised 08/10)

PERSONAL INFORMATION

Last Name:

First:

□ Mr.

Marital status (circle one)

□ Miss

□ Mrs.

Single / Mar / Div / Sep / Wid

□ Ms.

Date of Birth:

Street address/apt:

Home phone:

Cell phone:

(

)

(

)

City:

State/zip code:

Email address:

RELIGIOUS BACKGROUND

Baptized: □ Yes* □ No

Religion:

Date of Baptism:

*please provide a baptismal certificate

Church of Baptism:

Address ( city/state)

MARRIAGE INFORMATION

If Married, is this your first marriage? □ Yes □ No*

Is this your spouse’s first marriage? □ Yes □ No*

Name of Spouse: (include maiden name)

Spouse’s religion:

Church of Marriage:

Date:

Address of Church:

City/State

Married by:

□ priest □ minister □ rabbi □ imam □ justice of the peace □ other

If not married in a church, list location and address where marriage took place:

IF ENGAGED, is this your first marriage? □ Yes □ No*

Is this your fiancé/fiancée’s first marriage? □ Yes □ No*

Fiancé/fiancée’s Name:

When do you plan to be married?

Where?

*IF this is NOT your First Marriage or your spouse’s/fiancé’s (fiancée’s) first marriage:

Spouse’s Name from first marriage:

Religion:

Date of this marriage:

Married by:

□ priest □ minister □ rabbi □ imam □ justice of the peace □ other

*Church or location/address of marriage:

How did this marriage end: □ divorce □ death □ annulment

Date:

Inquirer'S Interview/information Form

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