Family Name (only)     Phone or
Street or P.O.     City, State Zip    
Email     Special Contact

First Name     Initial    Maiden (if applicable)
D.O.B.(mm/dd/yy)    Sex (M/F)    Marital Status (S/M/D/W/Wr)
Occupation     Work Phone
Sacraments (List date if known.  If not, indicate "Yes" or "No")
Baptism    First Communion    Confirmation    Marriage

Parish Involvement (list any liturgical ministries, parish activities, committees, councils, etc.).
Current
Future Interests

Spouse Name     Initial    Maiden (if applicable)
D.O.B. (mm/dd/yy)    Sex (M/F)    Marital Status (S/M/D/W/Wr)
Occupation     Work Phone
Sacraments (List date if known.  If not, indicate "Yes" or "No")
Baptism    First Communion    Confirmation    Marriage

Parish Involvement (list any liturgical ministries, parish activities, committees, councils, etc.).
Current
Future Interests

Top of Form

Children (List Children living at home, in college or in service)

First Name    Middle Name    D.O.B.    Married (Y/N)

Sacraments (Indicate date, name of church and location of church)
Baptism: Date    Church    Location
First Communion: Date    Church    Location
Confirmation: Date   Church     Location

School    Grade    Religious Education     College    Service

 Top of Form

First Name    Middle Name    D.O.B.    Married (Y/N)

Sacraments (Indicate date, name of church and location of church)
Baptism: Date    Church    Location
First Communion: Date    Church    Location
Confirmation: Date   Church     Location

School    Grade    Religious Education     College    Service

Top of Form

First Name    Middle Name    D.O.B.    Married (Y/N)

Sacraments (Indicate date, name of church and location of church)
Baptism: Date    Church    Location
First Communion: Date    Church    Location
Confirmation: Date   Church     Location

School    Grade    Religious Education     College    Service

Top of Form

First Name    Middle Name    D.O.B.    Married (Y/N)

Sacraments (Indicate date, name of church and location of church)
Baptism: Date    Church    Location
First Communion: Date    Church    Location
Confirmation: Date   Church     Location

School    Grade    Religious Education     College    Service

Top of Form

First Name    Middle Name    D.O.B.    Married (Y/N)

Sacraments (Indicate date, name of church and location of church)
Baptism: Date    Church    Location
First Communion: Date    Church    Location
Confirmation: Date   Church     Location

School    Grade    Religious Education     College    Service

Top of Form

Other children (adult, if married give married name & spouse):
   
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Others at this address.  Indicate relationship.
   

Special items such as shut-ins, in a nursing home, if you are gone for long periods of time.