Parish Census Form

Download Parish Census Form or fill out below and click on the SUBMIT button at the bottom.

Salutation (Mr./Mrs./Ms.)
Family Name:
Address:
City:
State:	Zip:-
Registered at St. Andrew (Month/Year):
Former Parish:

Home Phone:
Lived at this address since (Month/Year):
Marital Status:	Single Married Divorced Separated Widowed Other

Please complete for both	Head of Household	Spouse

First Name
Nick Name
Middle Name
Gender (M/F)
Email address:
Email address verified:
Cell Phone Number
Date of Birth
Place of Birth
Religion
Baptized Date
Baptized Place: Church/Location
Communion Date:
Communion Place Church/Location
Confirmation Date:
Confirmation Place: Church/Location
Marriage: Anniversary Date
Marriage Place: Church/Location
Ethnicity (White/Hispanic/Asian, etc.)
Main Language
Second Language
Highest Grade Completed
Handicap (N/Y[Type])	Yes	Yes

Employer
Occupation or Position
Retired	Yes	Yes
Graduate of St. Andrews (N/Y[Year])	Yes	Yes

Please enter the requested information for each dependent child living in household. For families with more than six children, additional Forms are available in the back of church or by contacting the rectory. Adult children living at home (either post-college age or employed) register separately.

You may also use this side of the form to include any dependent relative (grandparent, parent, sibling, etc.) residing in the household for period of time. Relatives residing in the household but not dependent on the head of household should also register separately.


Please complete for each child	Child	Child	Child	Child	Child	Child

First Name
Nick Name
Middle Name
Gender (M/F)
Email address:
Email address verified:
Cell Phone Number
Date of Birth
Place of Birth
Religion
Baptized Date
Baptized Place: Church/Location
Communion Date:
Communion Place Church/Location
Confirmation Date:
Confirmation Place: Church/Location
Marriage: Anniversary Date
Marriage Place: Church/Location
Ethnicity (White/Hispanic/Asian, etc.)
Main Language
Second Language
Highest Grade Completed
Handicap (N/Y[Type])	Yes	Yes	Yes	Yes	Yes	Yes

Attends St Andrew School (N/Y[Grade])	Yes	Yes	Yes	Yes	Yes	Yes
Graduate of St. Andrews (N/Y[Year])	Yes	Yes	Yes	Yes	Yes	Yes
Attends St. Andrew CCD Program?	Yes	Yes	Yes	Yes	Yes	Yes
Home Schooled (N/Y[Grade])	Yes	Yes	Yes	Yes	Yes	Yes