RCIA Registration Form

MARITAL STATUS *

Single

Married

UPLOAD FILE OF I/C SCAN *

PLACE OF MARRIAGE (If Married) *

OCCUPATION *

UPLOAD FILE OF BIRTH CERT SCAN *

NAME *

GENDER *

Male

Female

TELEPHONE NUMBER *

Church of Our Mother of Perpetual Help,

Ipoh, Malaysia

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

NUMBER OF CHILDREN *

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RCIA Registration Form

​​Church of Our Mother of Perpetual Help,

Ipoh, Malaysia

Church of Our Mother of Perpetual Help,