Inurnment and Burial Planning Guide/Saint Raphael Catholic Parish/Raleigh, NC

Your Name REQUIRED Please fill out this field. Please enter valid data.

Your Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Please select one REQUIRED Cell Phone Home Phone Business Phone Please fill out this field.

Your Email Please enter an email address.

Your address REQUIRED Please fill out this field. Please enter valid data.

Your relationship to the deceased REQUIRED Please fill out this field. Please enter valid data.

Current Legal Name of the Deceased REQUIRED Please fill out this field. Please enter valid data.

Legal Birth Name of the Deceased, if different from above Please enter valid data.

Deceased Date of Birth REQUIRED Please fill out this field. Please enter a date.

Deceased Date of Death REQUIRED Please fill out this field. Please enter a date.

Deceased Address REQUIRED Please fill out this field. Please enter valid data.

Surviving spouse's full name, if applicable Please enter valid data.

Liturgies and Services Planned (Check all that apply) REQUIRED Graveside Burial Inurnment Please fill out this field.

Remains of the Deceased REQUIRED Casket Cremation Please fill out this field.

Deceased will be REQUIRED Inurned in the Columbarium at St. Raphael Buried at a local cemetery Please fill out this field.

For Inurnment at St. Raphael: Wall and niche if known Please enter valid data.

Funeral Home REQUIRED Please fill out this field. Please enter valid data.

Funeral Home Contact Person's Name REQUIRED Please fill out this field. Please enter valid data.

Funeral Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Is the deceased Catholic? REQUIRED Yes No Please fill out this field.

What parish is the deceased a member at? (Please give the parish name and city and state) REQUIRED Please fill out this field. Please enter valid data.

This section will be completed by the St. Raphael funeral volunteers after form is submitted

Presider Please enter valid data.
Inurnment Date and Time Please enter valid data.
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