Saint Raphael New Parishioner Registration
We're so excited to welcome you into our Parish Family!  If you have more than 2 adult members, or more than 3 child members in your family, please submit a second form.  If you have any questions, please call the Parish Center at 412-661-3100.

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Family Name
Preferred Way to Address Mail
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Home Address
City, State, Zip Code
Home Phone Number
(XXX) XXX-XXXX
Email Address
Interested in donating online with Faith Direct?
Visit www.faithdirect.net for more information
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We are interested in learning more about the following ministries:
Adult Member #1 (Head of Household)
18 years or older
Data Code
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Current Marital Status
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First Name, Middle Name
Maiden Name (if applicable)
Sex
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Birthday
XX/XX/XXXX
Address, if different than above
Cell Phone
(XXX) XXX-XXXX
Occupation
Work Phone Number
(XXX) XXX-XXXX
What is your baptismal status?
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If baptized, please list date/location
Have you received your First Communion?
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If yes, date/location
Have you received the sacrament of Confirmation?
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If yes, date/location
If married, date and location of wedding
How often do you attend Mass?
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Adult Member #2
18 years or older
Data Code
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Current Marital Status
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First Name, Middle Name
Maiden Name (if applicable)
Sex
Clear selection
Birthday
XX/XX/XXXX
Address, if different than above
Cell Phone
(XXX) XXX-XXXX
Occupation
Work Phone Number
(XXX) XXX-XXXX
What is your baptismal status?
Clear selection
If baptized, please list date/location
Have you received your First Communion?
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If yes, date/location
Have you received the sacrament of Confirmation?
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If yes, date/location
If married, date and location of wedding
How often do you attend Mass?
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Child Member #1
17 years or younger
Data Code
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First Name, Middle Name
Sex
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Birthday
(XX/XX/XXXX)
Age
School
Grade
What is the child's baptismal status?
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If baptized, date/location
Has the child received his/her First Communion?
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If yes, date/location
Has the child been confirmed?
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If yes, date/location
Child Member #2
17 years or younger
Data Code
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First Name, Middle Name
Sex
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Birthday
(XX/XX/XXXX)
Age
School
Grade
What is the child's baptismal status?
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If baptized, date/location
Has the child received his/her First Communion?
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If yes, date/location
Has the child been confirmed?
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If yes, date/location
Child Member #3
17 years or younger
Data Code
Clear selection
First Name, Middle Name
Sex
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Birthday
(XX/XX/XXXX)
Age
School
Grade
What is the child's baptismal status?
Clear selection
If baptized, date/location
Has the child received his/her First Communion?
Clear selection
If yes, date/location
Has the child been confirmed?
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If yes, date/location
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