Parish Census Form

64 Church Street, Gilbertville, MA 01031 Tel. 413.477.6493  Fax. 413.477.0140

 

Thank you for taking the time to fill out our online census form.  Please complete all fields that are applicable.  This information will help us maintain accurate records of all our parishioners.

General Family Information

Family Surname:

 

Mailiing Address:

 

City:

 

State:

 

Zip Code:

 

Street Address (if differnt than above):

 

City:

 

State:

 

Zip Code:

 

Home Telephone:

 

Spouse / Single Adult

Title:

 

First Name:

 

Middle Name:

 

Last Name:

 

Date of Birth:

 

Occupation:

 

Employer:

 

Work Phone:

 

Highest Year of School Completed:

 

Sacraments Completed

 

 

Baptism:

 

Baptism Location:

 

Baptism Date:

 

Communion:

 

Confession:

 

Confirmation:

 

Confirmation Location:

 

Confirmation Date:

 

Spouse

Title:

 

First name:

 

Middle Name:

 

Last Name:

 

Date of Birth:

 

Date of Catholic Marriage:

 

Location of Catholic Marriage:

 

Highest Year of School COmpleted:

 

Occupation:

 

Employer:

 

Work Phone:

 

Spouse Sacraments Completed

 

 

Baptism:

 

Baptism Location:

 

Baptism Date:

 

Communion:

 

Confession:

 

Confirmation:

 

Confirmation Location:

 

Confirmation Date:

 

Child 1

First Name:

 

Middle Name:

 

Last Name:

 

Current School:

 

Grade:

 

Gender:

 

Child 1 Sacraments Completed

 

 

Baptism:

 

Baptism Location:

 

Baptism Date:

 

Communtion:

 

Confession:

 

Confirmation:

 

Confirmation Location:

 

Confirmation Date:

 

Child 2

First Name:

 

Middle Name:

 

Last Name:

 

Current School:

 

Grade:

 

Gender:

 

Child 2 Sacraments Completed

 

 

Baptism:

 

Baptism Location:

 

Baptism Date:

 

Communion:

 

Confession:

 

Confirmation:

 

Confirmation Location:

 

Confirmation Date:

 

Child 3

First Name:

 

Middle Name:

 

Last Name:

 

Current School:

 

Grade:

 

Gender:

 

Child 3 Sacraments Completed:

 

 

Baptism:

 

Baptism Location:

 

Baptism Date:

 

Communion:

 

Confession:

 

Confirmation:

 

Confirmation Location:

 

Confirmation Date:

 

Child 4

First Name:

 

Middle Name:

 

Last Name:

 

Current School:

 

Grade:

 

Gender:

 

Child 4 Sacraments Completed:

 

 

Baptism:

 

Baptism Location:

 

Baptism Date:

 

Communion:

 

Confession:

 

Confirmation:

 

Confirmation Location:

 

Confirmation Date:

 

Other / Adult

Title:

 

First Name:

 

Middle Name:

 

Last Name:

 

Date of Birth:

 

Occupation:

 

Employer:

 

Work Phone: