Initial Inquiry Form
(Please Print this page, fill it out, and mail it to us. Thank you.)
Please Mail to P. O. Box 26022 • Cincinnati 45226-0022 or FAX to (513) 321 - 3777
If you have questions and would like to phone: (513) 924 - 0111

Date:_________ Phone: _________________ Email:____________________________________

Name:__________________________ Address (Street/City/State/Zip): ______________________

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Birthdate: ___________ Place of Birth: _____________________ Height: ______ Weight: ______

Are you a U.S. Citizen? _____ Your health is: Excellent _____ Good ______ Fair _____ Poor _____

1. Are you a life-long Catholic? ____ If no, when did you join? _____________________________

What is your current parish? ________________________________________________________

Are you active as a lector, choir member, catechist, parish council member, etc.? ________________

If yes, in what capacity? ___________________________________________________________

Have you been involved in adult religious education or retreats in the past 5 years? _____________

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2. Are you a high school/GED graduate? _____________________ Year of graduation: _________

3. Are you a college graduate? ____ If yes, the year of graduation and from where: ______________

If yes, what was your field of study? __________________________________________________

4. What is your current employment? _________________________________________________

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How long have you worked with this company or organization? ____________________________

Is this full-time or part-time employment? _____________________________________________

Have you been employed elsewhere in the past ten years? _________________________________

5. Have you served in the U.S. Armed Forces? ____ What branch? ___________________________

Did you receive an Honorable Discharge? ____________________ When? ___________________

6. Are you taking any short term or long term medications? ________________________________

If yes, would you indicate the name and reasons for these prescriptions? ______________________

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7. Have you ever been married? _____ Do you have any dependent children? __________________

8. Have you ever been a member of a religious community/order as a candidate, novice,

professed member or as a seminarian? ____ If yes, please state where and when _________________

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9. Your current living situation is: with my family ____ on my own ____ other _________________

10. Have you ever been arrested? ___ Are you now on parole or probation? ____________________

11. Within the past year have you discussed your interest in religious life with someone? _________

If yes, with whom? _______________________________________________________________

12. For how long have you considered religious life? _____________________________________

13. For what type of ministry do you believe you are trained or prepared? _____________________

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I understand that this is NOT an application for the Brothers of the Poor of St. Francis.
The information I have given is correct to the best of my knowledge.

Your Signature: _______________________________________________Date: ______________