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MM slash DD slash YYYY
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Yes
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No
Are there any members of your household who would like to be visited by a priest?
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Date of Marriage
MM slash DD slash YYYY
Spouses Information
Spouse's Name
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Husband
Wife
Spouse's Date of Birth
MM slash DD slash YYYY
Spouse's Email
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Baptized?
Yes
No
Catholic?
Yes
No
Confirmed Catholic?
Yes
No
Confirmed Non-Catholic
Yes
No
Household information
Do you have any dependents living with you?
Yes
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How many?
1
2
3
4
5
Dependent #1
Relationship #1
Son
Daughter
Mother
Father
Other
#1 First and Last Name
#1 Gender
Male
Female
#1 Date of Birth
MM slash DD slash YYYY
#1 Sacraments Received
Baptism
Eucharist
Reconciliation
Confirmation
Dependent #2
Relationship #2
Son
Daughter
Mother
Father
Other
#2 First and Last Name
#2 Gender
Male
Female
#2 Date of Birth
MM slash DD slash YYYY
#2 Sacraments Received
Baptism
Eucharist
Reconciliation
Confirmation
Dependent #3
Relationship #3
Son
Daughter
Mother
Father
Other
#3 First and Last Name
#3 Gender
Male
Female
#3 Date of Birth
MM slash DD slash YYYY
#3 Sacraments Received
Baptism
Eucharist
Reconciliation
Confirmation
Dependent #4
Relationship #4
Son
Daughter
Mother
Father
Other
#4 First and Last Name
#4 Gender
Male
Female
#4 Date of Birth
MM slash DD slash YYYY
#4 Sacraments Received
Baptism
Eucharist
Reconciliation
Confirmation
Dependent #5
Relationship #5
Son
Daughter
Mother
Father
Other
#5 First and Last Name
#5 Gender
Male
Female
#5 Date of Birth
MM slash DD slash YYYY
#5 Sacraments Received
Baptism
Eucharist
Reconciliation
Confirmation
Welcome
Mass & Sacraments
Faith Formation
St. Mary’s Outreach
Get Involved
Stewardship
Welcome
Mass & Sacraments
Faith Formation
St. Mary’s Outreach
Get Involved
Stewardship
Archives
Bulletins
St. Raphael Family Resource Center
Pastor’s Corner
Online Giving
Archives
Bulletins
St. Raphael Family Resource Center
Pastor’s Corner
Online Giving