Our Lady of Africa Mbuya Catholic Parish - Annual Parishioner Survey  
Annual Parish Catholic Faithful Household Survey
Name of Church Member Surname *
Name of Church Member  First Name *
Member Telephone /Mobile Number  *
Please provide  your number if you wish to be contacted by the  Parish Administration 
Gender  *
Date of Birth for Member *
MM
/
DD
/
YYYY
Tick the Sacraments Received  *
YES
NO
Baptism
Holy Eucharist
Confirmation
Last Commitment
Holy Matrimony
Ordained Ministry
Education Level  *
Member  Professional /Occupation 
Nature of Occupation  *
2 Thessalonians 3:10 – "If anyone is not willing to work, let him not eat."  
Marital Status  *
Name of Spouse :
Name the person if married in church or separated 
Residential address  (within the Parish), Zone and Street *
What Mass do you attend on Sunday  *
Acts 20:7 – "On the first day of the week we came together to break bread."  
Do you attend Daily Mass ?  *
Malachi 1:11 – "From the rising of the sun to its setting, my name will be great among the nations, and in every place incense and a pure offering will be brought to my name.  
Name of Sub Parish  *
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