CHURCH OF OUR MOTHER OF PERPETUAL HELP IPOH GARDEN, 31400 IPOH.

(Tel. 05-5458220)

ADULT ENQUIRY TO THE CATHOLIC FAITH (RCIA)

YEAR OF BIRTH *

Address: Church: 1 Jalan Serindik; Redemptorists Community: 19-21 Jalan la Salle; 31400 Ipoh, Perak, Malaysia; Tel: (60) 05 5458220; Email: omphip@gmail.com; FaceBook: https://m.facebook.com/OMPHipoh/

PRESENT RELIGION *

ADDRESS *

LANGUAGE PREFERRED *

English

Chinese (Mandarin)

Tamil

RCIA Registration Form

MARITAL STATUS *

Single

Married

UPLOAD FILE OF I/C SCAN *

NUMBER OF CHILDREN *

PLACE OF MARRIAGE (If Married) *

OCCUPATION *

UPLOAD FILE OF BIRTH CERT SCAN *

NAME *

GENDER *

Male

Female

TELEPHONE NUMBER *

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Church of Our Mother of Perpetual Help,

RCIA Registration Form

​​Church of Our Mother of Perpetual Help,

Ipoh, Malaysia

Church of Our Mother of Perpetual Help,