St. Richard Census Form

Instructions

We appreciate your time in helping us to update our parish records. The information requested below is based upon the
information that we keep on file for each household. In order to compile the most accurate information on our families we
ask that you complete all of the fields that pertain to your household. When finished click "Submit." If you have completed
all of the required fields you will then return to the St. Richard Home Page. If you have left required fields empty you will
be prompted to complete the missing information wherepuon you can resubmit your information when finished. Thank you
for your assistance with this project!

Please Note

  • This form requires that javascript be enabled on your web browser. This feature is enabled on browsers by default. If you manually disabled javascript you must enable it again for the form to display properly and to submit the form.
  • There is a known issue with the MSN Explorer web browser. Those using this web browser will not be able to successfully submit the form because the browser does not properly display the year fields for date of birth. If you use this web browser, please switch to an alternate browser such as Firefox, Internet Explorer, Opera, etc. to submit the form.
MAILING INFORMATION:
Address Line 1:
Address Line 2:
City:
State:
Zip Code:
CONTACT INFORMATION:
Home Phone:
Alternate Phone 1: Cell: Office: Other:
Alternate Phone 2: Cell: Office: Other:
Email:
Would you like to receive occasional emails regarding happenings and events at the parish?     YesNo
HOUSEHOLD DETAILS:
Head of Household:
Last Name:
Maiden:
First Name:
Date of Birth: / /
Gender:
Occupation:
Ethnicity:
Religion:
Marital Status:
Date of Marriage: / /
Were you married by a Catholic priest?     YesNo
Baptized:
Confirmation:
Holy Communion:
Spouse:
Last Name:
Maiden:
First Name:
Date of Birth: / /
Gender:
Occupation:
Ethnicity:
Religion:
Baptized:
Confirmation:
Holy Communion:
Child 1:
Last Name:
First Name:
Date of Birth: / /
Gender:
Ethnicity:
School:
Religion:
Baptized:
Confirmation:
Holy Communion:
Child 2:
Last Name:
First Name:
Date of Birth: / /
Gender:
Ethnicity:
School:
Religion:
Baptized:
Confirmation:
Holy Communion:
Child 3:
Last Name:
First Name:
Date of Birth: / /
Gender:
Ethnicity:
School:
Religion:
Baptized:
Confirmation:
Holy Communion:
Additional Household Members:
Member 1:
Last Name:
First Name:
Relation to Head of Household:
Date of Birth: / /
Gender:
Occupation:
Ethnicity:
School:
Religion:
Baptized:
Confirmation:
Holy Communion:
Member 2:
Last Name:
First Name:
Relation to Head of Household:
Date of Birth: / /
Gender:
Occupation:
Ethnicity:
School:
Religion:
Baptized:
Confirmation:
Holy Communion: