Census Form Blank Form (#6)Family NameAddressYear of RegistrationDo you attend Mass in another church?YesNoDate of CensusPhone/MobileEmailEnvelope #How Often?Please list the languages spoken in your home1) First NameDate of BirthRelationshipSex (M or F)Marital StatusReligionIf you received these Sacraments, please check off Item 1 Item 2 Item 32) First NameDate of BirthRelationshipSex (M or F)Marital StatusReligionIf you received these Sacraments, please check off Item 1 Item 2 Item 33) First NameDate of BirthRelationshipSex (M or F)Marital StatusReligionIf you received these Sacraments, please check off Item 1 Item 2 Item 3Do you have any children living in your household? Yes NoIf yes, please list their schools and current grades. If they attend a non-catholic school, do they attend religious education classes?Child's NameSchool's NameGradeReligious EducationDo any members of your household belong to any of our Parish Groups or Organizations? Yes NoIf yes, please list them on the lines below:Parishioner's NameParish Group or OrganizationDoes anyone in your household have a profession, talent, hobby, or interest that they would like to share with the Parish or to help meet Parish needs? Yes NoIf yes, would you like to share with us. Please use the lines below to explain / elaborateAny members of your household homebound or disabled? Yes, Adult. Yes, Child NoWould you like Priest and Minister of Holy Communion to visit your homebound family member. Yes NoDo you have any concerns that you would like to discuss with Parish Priest or Staff member? Item 1 Item 2 Item 3Submit Form
