EOL Parish Census
Please complete ALL information so we can update our records to better serve you. This information is strictly confidential for pastoral use only and will not be given out to unauthorized personnel.

The first part of the form is for your household—that is, EVERYONE living in your home. If you are married and your spouse is not Catholic, you must still complete the form. The following section is requested for each person over 18 in the household. If an adult child is living with you (over 18) they must complete their own census form, even if the first several questions have the same responses as yours. If you need to make a note, such as regarding approximate date, or place of baptism, you my do so at the end.

Note that there is space for three adults and three children per household. You may not need all of the spaces, in that case, simply click NEXT on the form. If you need additional spaces, please use another form. You will only need to enter the Family Name, then advance to the section you need. Feel free to email tmanderino@dioceseofgreensburg.org if you have any questions.

Last Name / Family name
Your answer
Household Type
Home Address - Street, Town, State, ZIP
Your answer
Home Phone
Your answer
Cell Phone His
Your answer
Cell Phone Hers
Your answer
Cell Phone Other
Your answer
Permission to publish phone number
Email address for each adult
Your answer
Do you have Internet access at home?
Do you use a cell phone / tablet to go online?
I currently receive contribution envelopes.
I prefer:
Describe your family Mass participation: Male
Describe your family Mass participation: Female
Describe your family Mass participation: Other Adult
Describe your family Mass participation: Child(ren)
Is there something that would make you interested in attending Mass more often?
Your answer
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