Census

Please fill out the form below:

Date

Number In Household

Address

City

State

Zipcode

Country

Phone Number

Cell Phone Number

Email

Family Member Information

Complete one block for each family member – Including children

********************* Family Member 1 **************************

Full Name

Gender

Birth Date
Month Day Year

Marital Status

School

Grade

Highest Degree

Occupation

Employer

Religion

Baptism
Yes  No

First Communion
Yes  No

Confirmation
Yes  No

Date of Marriage
Month Day Year

Maiden Name

Place of Marriage (Church)

Place of Marriage (City)

Place of Marriage (State)

********************* Family Member 2 **************************

Full Name

Gender

Birth Date
Month Day Year

Marital Status

School

Grade

Highest Degree

Occupation

Employer

Religion

Baptism
Yes  No

First Communion
Yes  No

Confirmation
Yes  No

Date of Marriage
Month Day Year

Maiden Name

Place of Marriage (Church)

Place of Marriage (City)

Place of Marriage (State)

********************* Family Member 3 **************************

Full Name

Gender

Birth Date
Month Day Year

Marital Status

School

Grade

Highest Degree

Occupation

Employer

Religion

Baptism
Yes  No

First Communion
Yes  No

Confirmation
Yes  No

Date of Marriage
Month Day Year

Maiden Name

Place of Marriage (Church)

Place of Marriage (City)

Place of Marriage (State)

********************* Family Member 4 **************************

Full Name

Gender

Birth Date
Month Day Year

Marital Status

School

Grade

Highest Degree

Occupation

Employer

Religion

Baptism
Yes  No

First Communion
Yes  No

Confirmation
Yes  No

Date of Marriage
Month Day Year

Maiden Name

Place of Marriage (Church)

Place of Marriage (City)

Place of Marriage (State)

********************* Family Member 5 **************************

Full Name

Gender

Birth Date
Month Day Year

Marital Status

School

Grade

Highest Degree

Occupation

Employer

Religion

Baptism
Yes  No

First Communion
Yes  No

Confirmation
Yes  No

Date of Marriage
Month Day Year

Maiden Name

Place of Marriage (Church)

Place of Marriage (City)

Place of Marriage (State)

********************************************************************

Parish Ministry: Please check the ministries that interest you and someone will contact you.
Extraordinary Minister of the Eucharist Lector Altar Server Usher CCD Teacher/Volunteer Community Dinner Greeter

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