RCIA Registration Form

OCCUPATION *

TELEPHONE NUMBER *

NOTE: NEXT REGISTRATION FOR THIS YEAR'S (2023) INTAKE IS IN JULY.

NUMBER OF CHILDREN *

YEAR OF BIRTH *

SALUTATION *

Mdm

PRESENT RELIGION *

UPLOAD FILE OF BIRTH CERT SCAN *

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GENDER *

Male

Female

ADDRESS *

Address: Church: 1 Jalan Serindek; 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/

LANGUAGE PREFERRED *

English

Chinese (Mandarin)

Tamil

MARITAL STATUS *

Single

Married

Church of Our Mother of Perpetual Help,

​RCIA Registration Form

​​Church of Our Mother of Perpetual Help,

Ipoh, Malaysia

RCIA Registration Form

Church of Our Mother of Perpetual Help,