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St. Patrick Catholic Church
Baton Rouge, LA
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Ministries
Ministry Sign Up
Youth Ministry
That Man Is You
Spiritual Direction
Respect Life
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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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Zip
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Home Phone
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Marital Status
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Catholic Marriage
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Civil Marriage
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Would you like your name, address, and phone number included in the parish directory?
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Yes
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HEAD OF HOUSEHOLD
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
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Male
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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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SPOUSE
First Name
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Last Name
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Title
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Mr.
Mrs.
Miss
Ms.
Dr.
Suffix
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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
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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
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CHILD OR OTHER ADULT 1
First Name
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Last Name
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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
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Annulled
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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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Last Name
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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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Single
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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 3
First Name
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Last Name
REQUIRED
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Goes by (nickname)
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Maiden Name
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Title
None
Mr.
Mrs.
Ms.
Miss
Dr.
Suffix
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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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Single
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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 4
First Name
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Last Name
REQUIRED
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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 5
First Name
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Last Name
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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
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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 6
First Name
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Last Name
REQUIRED
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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
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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 7
First Name
REQUIRED
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Last Name
REQUIRED
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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
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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 8
First Name
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Last Name
REQUIRED
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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
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Last Name
REQUIRED
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Goes by (nickname)
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Maiden Name
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Title
None
Mr.
Mrs.
Ms.
Miss
Dr.
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None
Jr.
Sr.
II
III
IV
Relationship to Head of Household
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Grade/Degree
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Gender
None
Male
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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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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
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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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Last Name
REQUIRED
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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
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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
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Last Name
REQUIRED
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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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Separated
Engaged
Annulled
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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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