St. Raphael Registration Form
Mailing Address: 1221 Azalea Drive, Munster, IN 46321 * (219) 798-3331 * raphaelnwi.org
Email address *
Welcome to the Church of St. Raphael the Archangel
Upon your completion of the registration form for St. Raphael, our office will properly record your personal data and sacramental records in our database. We want to assist you in keeping track of the important faith events in your life and be able to provide information in a timely manner to make your faith journey enjoyable and easy.

When you register at The Church of St. Raphael the Archangel, the church can better assist you with sacramental record keeping, wedding preparation, completion of sacraments, funeral arrangements, sick calls, homebound or hospital outreach opportunities, taxable donation documentation, and much more. As a registered family St. Raphael benefits from having a history of your family's time, talent, and treasure.

As you review your options for tithing, we highly recommend you use online giving through PayPal ((You may text 729725 “Send $X to info@cecnwi.org”)). All tithing should reflect your prayerful discernment of how there is nothing your life that is outside of your relationship with Jesus Christ.

Thank you for taking the time to read through the information above. As Pastor, Shepherd, and Father of Saint Raphael Church, I welcome you and your family to our family. Please be sure to let me know when I can come and celebrate the Eucharist with your family in your home.

Today's Date *
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FAMILY INFORMATION
Family Name *
Your answer
Your Information
First Name
Your answer
Cell #
Your answer
Date of Birth
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Occupation
Your answer
Spouse (If Any) Information
Spouse Name
Your answer
Cell #
Your answer
Date of Birth
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Occupation
Your answer
Family Info Cont'd.
Primary Home Phone#
Your answer
Marital Status
Local Address Street
Your answer
Local Address City
Your answer
Local Address State
Local Address Postal Code
Your answer
Alternative Address
Your answer
Alternative Address for What Purpose
Children (If Any) Information
Child Name #1
Your answer
Child #1 Date of Birth
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Child # 1
Child # 1 Sacraments Needed
Child Name # 2
Your answer
Child #2 Date of Birth
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DD
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YYYY
Child # 2
Child # 2 Sacraments Needed
Child Name # 3
Your answer
Child # 3 Date of Birth
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DD
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YYYY
Child # 3
Child # 3 Sacraments Needed
Child Name # 4
Your answer
Child # 4 Date of Birth
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Child # 4
Child # 4 Sacraments Needed
Family Info Cont'd.
I would like St. Raphael to contact me primarily by
Secondary Email address
Your answer
We offer online giving through PayPal. How would you like to give your tithe to St. Raphael?
I am a full time resident
Date we leave for alternative address
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Date we return from alternative address
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FAMILY INTEREST IN GROUPS AND MINISTRIES
Please check where there is interest or experience.
Primary
Spouse
Child # 1
Child # 2
Child # 3
Child # 4
Altar Server
Bereavement Ministry
Bible/Small Group Study
Young Adult Activities
Children's Liturgy
Children's Nursery Ministry
Eucharistic Minister
Evangelism Ministry
Friends & Family Fellowship Ministry
Lector Ministry
Media Ministry
Men's Group
Music Ministry
Eucharistic Adoration
Prison Ministry
Respect Life Ministry
Social Justice Ministry
Sacramental Outreach Ministry
Youth Group
Welcome Ministry
Women's Group
FAMILY SACRAMENT INFORMATION
Sacramental History (Check if the person has received the sacrament)
Primary Spouse
Spouse
Child # 1
Child # 2
Child # 3
Child # 4
Baptism
Confession
Reconciliation
Eucharist
Confirmation
Marriage
Ordination
Thank you for registering!
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