Parish Census / Registration
PLEASE Print Clearly
Family Last Name
Home Phone Number
Household
(
Parish
)
St. Hyacinth
Mailing Street Address
St. Patrick
Contribution Envelope #
City
If you do not receive offertory envelopes
now, would you like to in the future?
Zip Code
Yes
E-Mail Address
Do you require a year-end envelope
statement for tax purposes?
Yes
Main Contact Member
First Name
Last Name
Title (Mr., Ms., Dr., etc.)
Suffix
Date of Birth (MM/DD/YYYY)
Nick Name
/
)
City
State
Year
Church of Confirmation
City
State
Year
Religion (if not Catholic)
Marital Status
Single
Church of Marriage
First Name
Married
City
Last Name
Nick Name
Widowed
State
Suffix
Date of Birth (MM/DD/YYYY)
/
Spouse
Cell Number
(
/
/
No
Maiden Name (if applicable)
Church of Baptism
Title (Mr., Ms., Dr., etc.)
No
Separated
Year
Maiden Name (if applicable)
Cell Number
(
)
Church of Baptism
City
State
Year
Church of Confirmation
City
State
Year
Religion (if not Catholic)
E-Mail Address
Do you have a photo? Please consider including a personal or family photo with this form.
The picture does not need to be formal or professional — it is not for publication. It will
simply help the priests and parish staff recognize you and your family.
Additional Family Members
Please include additional members of your household below. A household consists of those children and
adults who live together in the family home as well as those who consider the family home to be their
permanent address (e.g. college students). Grown children who live outside the home should be
encouraged to register their own household in the parish in which they participate. Attach additional
forms as needed to accommodate each family member.
Family Member 4
Family Member 3
Family Member 2
Family Member 1
PLEASE Print Clearly
First Name
Last Name
Date of Birth (MM/DD/YYYY)
/
/
Gender
M
Suffix
Grade
Religious Education
TCA
F
Nick Name
(for children grades 1-8)
CCD
Other:
Church of Baptism
City
State
Year
Church of Confirmation
City
State
Year
First Name
Last Name
Date of Birth (MM/DD/YYYY)
/
/
Gender
M
Suffix
Grade
Religious Education
TCA
F
Nick Name
(for children grades 1-8)
CCD
Other:
Church of Baptism
City
State
Year
Church of Confirmation
City
State
Year
First Name
Last Name
Date of Birth (MM/DD/YYYY)
/
/
Gender
M
Suffix
Grade
Religious Education
TCA
F
Nick Name
(for children grades 1-8)
CCD
Other:
Church of Baptism
City
State
Year
Church of Confirmation
City
State
Year
Suffix
Nick Name
First Name
Last Name
Date of Birth (MM/DD/YYYY)
/
/
Gender
M
Grade
Religious Education
TCA
F
CCD
(for children grades 1-8)
Other:
Church of Baptism
City
State
Year
Church of Confirmation
City
State
Year
Organizations and Schools
Family Last Name
Parish
Main Contact First Name
St. Hyacinth
St. Patrick
Parish Organizations
The census is a great opportunity for all our parish organizations to update their contact
information. We would also like to invite everyone to consider other ways to participate in the
life of our parishes. Please write the first name of the household member who is involved or
may be interested in being involved in the appropriate box below.
Activity
Altar Server (4th grade +)
CCD Teacher, Aide, Sub
Choir / Cantor
Church Cleaning
Collection Counter
Cursillo (Spanish)
Dad's Club (TCA)
Extraordinary Minister
Grounds & Gardens
Legión de María (Spanish)
Mass Reader
Photographer (bulletin & web)
Sick / Nursing Home Visitor (SHIFT)
St. Hyacinth Altar and Rosary
St. Patrick IHM Sodality
Eucharistic Adorer
Usher / Greeter
Widows' Monthly Luncheon
Already Belong
Am Interested
Parish School Alumni
Did you or a household member graduate from one of our parish schools? We would like to
begin an alumni contact list for the graduates of St. Roch, St. Hyacinth, St. Patrick, LaSalle
Catholic, and Trinity Academy. Include your maiden name in parentheses if applicable.
Name
School
Class Year
Additional Family Members #5 - 8 (to be added to main registration form)
Please include additional members of your household below. A household consists of those children and
adults who live together in the family home as well as those who consider the family home to be their
permanent address (e.g. college students). Grown children who live outside the home should be
encouraged to register their own household in the parish in which they participate. Attach additional forms
as needed to accommodate each family member.
Family Member 8
Family Member 7
Family Member 6
Family Member 5
PLEASE Print Clearly
First Name
Last Name
Date of Birth (MM/DD/YYYY)
/
/
Gender
M
Suffix
Grade
Religious Education
TCA
F
Nick Name
(for children grades 1-8)
CCD
Other:
Church of Baptism
City
State
Year
Church of Confirmation
City
State
Year
First Name
Last Name
Date of Birth (MM/DD/YYYY)
/
/
Gender
M
Suffix
Grade
Religious Education
TCA
F
Nick Name
(for children grades 1-8)
CCD
Other:
Church of Baptism
City
State
Year
Church of Confirmation
City
State
Year
First Name
Last Name
Date of Birth (MM/DD/YYYY)
/
/
Gender
M
Suffix
Grade
Religious Education
TCA
F
Nick Name
(for children grades 1-8)
CCD
Other:
Church of Baptism
City
State
Year
Church of Confirmation
City
State
Year
Suffix
Nick Name
First Name
Last Name
Date of Birth (MM/DD/YYYY)
/
/
Gender
M
Grade
Religious Education
TCA
F
CCD
(for children grades 1-8)
Other:
Church of Baptism
City
State
Year
Church of Confirmation
City
State
Year