Diaconate Inquiry Form

Personal Information

Full Baptismal name (please include middle name) REQUIRED Please fill out this field. Please enter valid data.

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

Street Address REQUIRED Please fill out this field. Please enter valid data.

Mailing 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.

Social Security Number

(Your Social Security number will be used for a background check which will be completed by the Diocese of Lafayette)

Please enter valid data.

Home Phone REQUIRED Please fill out this field. Please enter a phone number.

Work Phone Please enter a phone number.

Cell Phone Please enter a phone number.

Primary Email REQUIRED Please fill out this field. Please enter an email address.

Work Email Please enter an email address.

When were you baptized Catholic? REQUIRED Please fill out this field. Please enter valid data.

If you are a convert to Catholicism, from what faith tradition do you come from? Please enter valid data.

Current (Registered) Church Parish REQUIRED Please fill out this field. Please enter valid data.

How long a member of the Church Parish? REQUIRED Please fill out this field. Please enter valid data.

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

Church Parish Office Number Please enter valid data.

Place of birth (city and state) REQUIRED Please fill out this field. Please enter valid data.

Have you spoken to your Pastor about your interest in the Diaconate? REQUIRED

Note: If not, do so before you submit this form

Yes No Please fill out this field.

Are you a U.S. Citizen? REQUIRED Yes No Please fill out this field.

If not, explain your residency status

Are you multi-lingual? REQUIRED Yes No Please fill out this field.

If yes, which languages? Please enter valid data.

Will you continue to reside in this diocese for at least 3 years after ordination? REQUIRED Yes No Please fill out this field.

If not, please explain:

Place of Employment REQUIRED Please fill out this field. Please enter valid data.

What type of work do you do? REQUIRED Please fill out this field.

How long have you been employed in this job? REQUIRED Please fill out this field. Please enter valid data.

Education Level REQUIRED

You must have a GED or a High School education to apply for formation

High School College Grad School (Masters Degree) Post Grad (Doctorate) GED Please fill out this field.

Current Marriage/Single Status

Marital Status REQUIRED Single Married Widowed Divorced Please fill out this field.

Spouse's Information (Required)

Wife's full baptismal name Please enter valid data.

Does your wife consent to your application for the Diaconate? Yes No

Current Marriage: Date of Sacramental Marriage Please enter valid data.

Date of Marriage (Civil if Applicable) Please enter valid data.

Was your current marriage validated within the Catholic Church? Yes No

If yes, what date? Please enter valid data.

Spouse's Occupation Please enter valid data.

Do you and your spouse have children? Yes No

If yes, please specify their ages.

Prior Marriages

If there have been prior marriages by you, or by your wife, the following information is needed for each marriage you have contracted. (Civil and Sacramental)

Yourself

Spouse's Name Please enter valid data.
Date of Marriage (Civil) Please enter valid data.
Date of Marriage (Catholic) Please enter valid data.
Date of Divorce Please enter valid data.
Date of Declaration of Nullity (annulment) Please enter valid data.
Case Number Please enter valid data.

Your Wife

Spouse's Name Please enter valid data.
Date of Marriage (Civil) Please enter valid data.
Date of Marriage (Catholic) Please enter valid data.
Date of Divorce Please enter valid data.
Date of Declaration of Nullity (annulment) Please enter valid data.
Case Number Please enter valid data.

Ministries

How many years in your ministries?

Were you trained in your ministries? REQUIRED Yes No Please fill out this field.

Are you currently or have you ever been an RCIA: Leader Teacher Sponsor Volunteer

Are you currently or have you ever been a CCD: Leader Teacher Volunteer

Are you currently or have you ever been an Adult Religious Formation: Leader Teacher Volunteer

Are you currently or have you ever been a Sacramental Preparation: Leader Teacher Volunteer

Other Ministries:

Social/Civic

What neighborhood, civic, social, or service organization(s) do you belong to? Please list below ministries/activities in the community with which you have been involved. Examples are: Right to Life; Food Banks; Habitat; Service to Youth/Schools; Providing transportation; etc.

Name of Activity Please enter valid data.

Were you a Leader? Yes No

Were you a Volunteer? Yes No

Please describe your ministry

Name of Activity Please enter valid data.

Were you a Leader? Yes No

Were you a Volunteer? Yes No

Please describe your ministry

Please elaborate on any current significant medical conditions for which you are seeking treatment?

Do you now, or have you ever, had a problem with or been treated for alcohol abuse, drug abuse, or other addictive or compulsive behaviors? REQUIRED Yes No Please fill out this field.

If yes, please explain (this information will be kept in strict confidence)

Have you ever been arrested, arraigned and/or convicted of any misdemeanor or felony? REQUIRED

Excluding Minor traffic violations

Yes No Please fill out this field.

In a short form (100 words or less) please explain why you are applying for the Permanent Diaconate. REQUIRED Please fill out this field.

Please note a background check will be completed by the Human Resources Department of the Diocese of Lafayette.

Diaconate Inquiry Form

Permanent Diaconate Eligibilty

Personal Information

Current Marriage/Single Status

Spouse's Information (Required)

Prior Marriages

Ministries

Social/Civic

News Releases

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