2013 Parish Census
* Required
Family Name
*
Your answer
Home Address
*
Your answer
Home Phone Number
Your answer
Are there people in the household who are homebound or sick that would like to receive Holy Communion at home on a monthly basis?
*
Yes
No
Would you like Father Chris or Deacon Bill to contact you and arrange a visit to your home for a "Home Blessing" and pastoral visit?
*
Yes
No
Is anyone in the household interested in becoming more involved in one of our ministries or perhaps starting a new ministry/group at this time (you will be contacted to help you discern where your gifts might best be used for the parish)?
*
Yes
No
Can you offer suggestions for ways we can improve our parish so that we will remain an amazing place where God is glorified and His people are sanctified (we really want to get as much feedback and ideas from people as possible)?
Your answer
Regarding envelopes that we use for our weekly tithe...
*
I receive them with no problems
I receive them but sometimes there are problems and they do not come
I do not receive them nor do I want to receive them
I do not receive them but would like to begin receiving them
Your answer
First and Last Name for Head of Household
*
Your answer
Date of Birth for Head of Housebold
Your answer
Cell Phone for Head of Household
Your answer
Email address for Head of Household
Your answer
Is the Head of Household a Catholic?
*
Yes
No
No, but interested in becoming a Catholic
Has Head of Household received Baptism, Confirmation & Eucharist?
*
Yes
No
Unsure at this time
Is Head of Household working or in school? Where/what are they doing?
Your answer
First and Last Name for Person #2
Your answer
Date of Birth for Person #2
Your answer
Cell Phone Number for Person #2
Your answer
Email address for Person #2
Your answer
is Person #2 a Catholic?
Yes
No
No, but interested in becoming Catholic
Clear selection
Has Person #2 received Baptism, Confirmation & Eucharist?
Yes
No
Unsure at this time
Clear selection
Is Person #2 working or in school? Where/what are they doing?
Your answer
First and Last Name for Person #3
Your answer
Date of Birth for Person #3
Your answer
Cell Phone Number for Person #3
Your answer
Email address for Person #3
Your answer
Is Person #3 a Catholic?
Yes
No
No, but interested in becoming a Catholic
Clear selection
Has Person #3 received the Sacraments of Baptism, Confirmation & Eucharist?
Yes
No
Unsure at this time
Clear selection
Is Person #3 in school or working? Where/what are they doing?
Your answer
First and Last Name for Person #4
Your answer
Date of Birth for Person #4
Your answer
Cell Phone Number for Person #4
Your answer
Email address for Person #4
Your answer
Is Person #4 a Catholic?
Yes
No
No, but interested in becoming Catholic
Clear selection
Has Person #4 received Baptism, Confirmation & Eucharist?
Yes
No
Unsure at this time
Clear selection
Is Person #4 working or going to school at this time? Where/what are they doing?
Your answer
First and Last Name for Person #5
Your answer
Date of Birth for Person #5
Your answer
Cell Phone Number for Person #5
Your answer
Email address for Person #5
Your answer
Is Person #5 a Catholic?
Yes
No
No, but interested in becoming a Catholic
Clear selection
Has Person #5 received the Sacraments of Baptism, Confirmation & Eucharist?
Yes
No
Unsure at this time
Clear selection
Is Person #5 working or going to school at this time? Where/what are they doing?
Your answer
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