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St. Patrick Catholic Church
Baton Rouge, LA
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Confidential Census Data Form
The maximum number of form submissions has been reached. This form is currently not available.
The information in the form will be held in strict confidence for pastoral use only. Your information is never given to outside parties.
HOUSEHOLD
Family Name
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Street Address
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City
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State
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DE
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KS
KY
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MD
ME
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MS
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Zip
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Home Phone
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Maximum 20 characters
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Please enter a phone number.
Marital Status
None
Catholic Marriage
Annulled Marriage
Other Church Marriage
Civil Marriage
Widowed
Single
Separated
Divorced
Engaged
Cohabiting
Would you like your name, address, and phone number included in the parish directory?
REQUIRED
Yes
No
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HEAD OF HOUSEHOLD
First Name
REQUIRED
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Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Title
None
Mr.
Mrs.
Miss
Ms.
Dr.
Suffix
None
Jr.
Sr.
II
III
IV
Nickname
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Maiden Name
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Religion
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Place of Employment/School
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Physical or Mental Disability
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Occupation
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Date of Birth
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Baptism Date, Church, City/State
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First Eucharist Date, Church, City/State
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Confirmation Date, Church, City/State
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Marriage Date, Church, City/State
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Gender
None
Male
Female
Phone Number
REQUIRED
Maximum 20 characters
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Please enter a phone number.
Email
REQUIRED
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Please enter an email address.
Ministries that you would like to join or would like more information about:
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SPOUSE
First Name
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Last Name
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Title
None
Mr.
Mrs.
Miss
Ms.
Dr.
Suffix
None
Jr.
Sr.
II
III
IV
Nickname
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Maiden Name
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Religion
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Place of Employment/School
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Physical or Mental Disability
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Occupation
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Date of Birth
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Baptism Date, Church, City/State
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First Eucharist Date, Church, City/State
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Confirmation Date, Church, City/State
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Marriage Date, Church, City/State
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Gender
None
Male
Female
Phone Number
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Email
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Ministries that you would like to join or would like more information about:
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Children and/or Other Adults in the Household
REQUIRED
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CHILD OR OTHER ADULT 1
First Name
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Please enter valid data.
Last Name
REQUIRED
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Please enter valid data.
Goes by (nickname)
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Maiden Name
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Title
None
Mr.
Mrs.
Ms.
Miss
Dr.
Suffix
None
Jr.
Sr.
II
III
IV
Relationship to Head of Household
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Grade/Degree
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Gender
None
Male
Female
Marital Status
None
Catholic Marriage
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Widowed
Single
Other Church Marriage
Cohabiting
Separated
Engaged
Annulled
Divorced
Date of Birth
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Religion
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Mental or Physical Disability
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Occupation
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Place of Employment/School
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Phone Number
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Email Address
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Baptism Date, Church, City/State
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First Eucharist Date, Church, City/State
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Confirmation Date, Church, City/State
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Marriage Date, Church, City/State
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CHILD OR OTHER ADULT 2
First Name
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Please enter valid data.
Last Name
REQUIRED
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Please enter valid data.
Goes by (nickname)
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Maiden Name
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Title
None
Mr.
Mrs.
Ms.
Miss
Dr.
Suffix
None
Jr.
Sr.
II
III
IV
Relationship to Head of Household
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Grade/Degree
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Gender
None
Male
Female
Marital Status
None
Catholic Marriage
Civil Marriage
Widowed
Single
Other Church Marriage
Cohabiting
Separated
Engaged
Annulled
Divorced
Date of Birth
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Religion
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Mental or Physical Disability
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Occupation
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Place of Employment/School
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Phone Number
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Email Address
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Baptism Date, Church, City/State
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First Eucharist Date, Church, City/State
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Confirmation Date, Church, City/State
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Marriage Date, Church, City/State
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CHILD OR OTHER ADULT 3
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Goes by (nickname)
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Maiden Name
Please enter valid data.
Title
None
Mr.
Mrs.
Ms.
Miss
Dr.
Suffix
None
Jr.
Sr.
II
III
IV
Relationship to Head of Household
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Grade/Degree
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Gender
None
Male
Female
Marital Status
None
Catholic Marriage
Civil Marriage
Widowed
Single
Other Church Marriage
Cohabiting
Separated
Engaged
Annulled
Divorced
Date of Birth
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Religion
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Mental or Physical Disability
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Occupation
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Place of Employment/School
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Phone Number
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Email Address
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Baptism Date, Church, City/State
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First Eucharist Date, Church, City/State
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Confirmation Date, Church, City/State
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Marriage Date, Church, City/State
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CHILD OR OTHER ADULT 4
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Goes by (nickname)
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Maiden Name
Please enter valid data.
Title
None
Mr.
Mrs.
Ms.
Miss
Dr.
Suffix
None
Jr.
Sr.
II
III
IV
Relationship to Head of Household
Please enter valid data.
Grade/Degree
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Gender
None
Male
Female
Marital Status
None
Catholic Marriage
Civil Marriage
Widowed
Single
Other Church Marriage
Cohabiting
Separated
Engaged
Annulled
Divorced
Date of Birth
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Religion
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Mental or Physical Disability
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Occupation
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Place of Employment/School
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Phone Number
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Email Address
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Baptism Date, Church, City/State
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First Eucharist Date, Church, City/State
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Confirmation Date, Church, City/State
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Marriage Date, Church, City/State
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CHILD OR OTHER ADULT 5
First Name
REQUIRED
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Last Name
REQUIRED
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Please enter valid data.
Goes by (nickname)
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Maiden Name
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Title
None
Mr.
Mrs.
Ms.
Miss
Dr.
Suffix
None
Jr.
Sr.
II
III
IV
Relationship to Head of Household
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Grade/Degree
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Gender
None
Male
Female
Marital Status
None
Catholic Marriage
Civil Marriage
Widowed
Single
Other Church Marriage
Cohabiting
Separated
Engaged
Annulled
Divorced
Date of Birth
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Religion
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Mental or Physical Disability
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Occupation
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Place of Employment/School
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Phone Number
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Email Address
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Baptism Date, Church, City/State
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First Eucharist Date, Church, City/State
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Confirmation Date, Church, City/State
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Marriage Date, Church, City/State
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CHILD OR OTHER ADULT 6
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Goes by (nickname)
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Maiden Name
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Title
None
Mr.
Mrs.
Ms.
Miss
Dr.
Suffix
None
Jr.
Sr.
II
III
IV
Relationship to Head of Household
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Grade/Degree
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Gender
None
Male
Female
Marital Status
None
Catholic Marriage
Civil Marriage
Widowed
Single
Other Church Marriage
Cohabiting
Separated
Engaged
Annulled
Divorced
Date of Birth
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Religion
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Mental or Physical Disability
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Occupation
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Place of Employment/School
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Phone Number
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Email Address
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Baptism Date, Church, City/State
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First Eucharist Date, Church, City/State
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Confirmation Date, Church, City/State
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Marriage Date, Church, City/State
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CHILD OR OTHER ADULT 7
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Goes by (nickname)
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Maiden Name
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Title
None
Mr.
Mrs.
Ms.
Miss
Dr.
Suffix
None
Jr.
Sr.
II
III
IV
Relationship to Head of Household
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Grade/Degree
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Gender
None
Male
Female
Marital Status
None
Catholic Marriage
Civil Marriage
Widowed
Single
Other Church Marriage
Cohabiting
Separated
Engaged
Annulled
Divorced
Date of Birth
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Religion
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Mental or Physical Disability
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Occupation
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Place of Employment/School
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Phone Number
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Email Address
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Baptism Date, Church, City/State
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First Eucharist Date, Church, City/State
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Confirmation Date, Church, City/State
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Marriage Date, Church, City/State
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CHILD OR OTHER ADULT 8
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Goes by (nickname)
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Maiden Name
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Title
None
Mr.
Mrs.
Ms.
Miss
Dr.
Suffix
None
Jr.
Sr.
II
III
IV
Relationship to Head of Household
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Grade/Degree
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Gender
None
Male
Female
Marital Status
None
Catholic Marriage
Civil Marriage
Widowed
Single
Other Church Marriage
Cohabiting
Separated
Engaged
Annulled
Divorced
Date of Birth
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Religion
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Mental or Physical Disability
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Occupation
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Place of Employment/School
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Phone Number
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Email Address
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Baptism Date, Church, City/State
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First Eucharist Date, Church, City/State
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Confirmation Date, Church, City/State
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Marriage Date, Church, City/State
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CHILD OR OTHER ADULT 9
First Name
REQUIRED
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Please enter valid data.
Last Name
REQUIRED
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Please enter valid data.
Goes by (nickname)
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Maiden Name
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Title
None
Mr.
Mrs.
Ms.
Miss
Dr.
Suffix
None
Jr.
Sr.
II
III
IV
Relationship to Head of Household
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Grade/Degree
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Gender
None
Male
Female
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None
Catholic Marriage
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Single
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Engaged
Annulled
Divorced
Date of Birth
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Religion
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Mental or Physical Disability
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Occupation
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Place of Employment/School
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Phone Number
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Email Address
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Baptism Date, Church, City/State
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First Eucharist Date, Church, City/State
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Confirmation Date, Church, City/State
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Marriage Date, Church, City/State
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CHILD OR OTHER ADULT 10
First Name
REQUIRED
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Please enter valid data.
Last Name
REQUIRED
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Please enter valid data.
Goes by (nickname)
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Maiden Name
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Title
None
Mr.
Mrs.
Ms.
Miss
Dr.
Suffix
None
Jr.
Sr.
II
III
IV
Relationship to Head of Household
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Grade/Degree
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Gender
None
Male
Female
Marital Status
None
Catholic Marriage
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Separated
Engaged
Annulled
Divorced
Date of Birth
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Religion
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Mental or Physical Disability
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Occupation
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Place of Employment/School
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Phone Number
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Email Address
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Baptism Date, Church, City/State
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First Eucharist Date, Church, City/State
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Confirmation Date, Church, City/State
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Marriage Date, Church, City/State
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CHILD OR OTHER ADULT 11
First Name
REQUIRED
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Please enter valid data.
Last Name
REQUIRED
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Please enter valid data.
Goes by (nickname)
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Maiden Name
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Title
None
Mr.
Mrs.
Ms.
Miss
Dr.
Suffix
None
Jr.
Sr.
II
III
IV
Relationship to Head of Household
Please enter valid data.
Grade/Degree
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Gender
None
Male
Female
Marital Status
None
Catholic Marriage
Civil Marriage
Widowed
Single
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Cohabiting
Separated
Engaged
Annulled
Divorced
Date of Birth
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Religion
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Mental or Physical Disability
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Occupation
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Place of Employment/School
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Phone Number
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Email Address
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Baptism Date, Church, City/State
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First Eucharist Date, Church, City/State
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Confirmation Date, Church, City/State
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Marriage Date, Church, City/State
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CHILD OR OTHER ADULT 12
First Name
REQUIRED
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Last Name
REQUIRED
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Please enter valid data.
Goes by (nickname)
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Maiden Name
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Title
None
Mr.
Mrs.
Ms.
Miss
Dr.
Suffix
None
Jr.
Sr.
II
III
IV
Relationship to Head of Household
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Grade/Degree
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Gender
None
Male
Female
Marital Status
None
Catholic Marriage
Civil Marriage
Widowed
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Cohabiting
Separated
Engaged
Annulled
Divorced
Date of Birth
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Religion
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Mental or Physical Disability
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Occupation
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Place of Employment/School
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Phone Number
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Email Address
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Baptism Date, Church, City/State
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First Eucharist Date, Church, City/State
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Confirmation Date, Church, City/State
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Marriage Date, Church, City/State
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