<p> WELCOME TO ST. DENNIS CHURCH PARISH CENSUS INFORMATION</p><p>ALL INFORMATION IS CONFIDENTIAL TODAY’S DATE: ______PLEASE PRINT Year you joined parish______Would you like envelopes? Yes….. No……</p><p>NAME______(MAIDEN NAME IF IT APPLIES)______First Middle Initial Last</p><p>ADDRESS______P.O.#______CITY______STATE_____ZIP______HOME PHONE:______</p><p>MARITAL STATUS: ______(S-Single, M-Married, D-Divorced, W-Widow/Widower) </p><p>CELL PHONE E-MAIL ADDRESS: ______</p><p>BIRTH DATE______MALE/FEMALE OCCUPATION:______EMPLOYED:_____BUSINESS PHONE______</p><p>RELIGION______SACRAMENTS YES OR NO BAPTISM____1ST COMMUNION_____CONFIRMATION______</p><p>CHURCH OF MARRIAGE______DATE OF MARRIAGE______</p><p>RACE (W-WHITE, AA- AFRICAN, AM. – W-WHITE, O - ORIENTAL, S-SPANISH ______FOREIGN LANUAGE SPOKEN?______</p><p>**********************************************************************************************</p><p>SPOUSE’S NAME:______(Nick Name)______MAIDEN NAME______CELL PHONE: CELL PHONE E-MAIL ADDRESS: ______</p><p>BIRTH DATE______MALE/FEMALE OCCUPATION:______EMPLOYED:_____BUSINESS PHONE______</p><p>RELIGION______SACRAMENTS YES OR NO BAPTISM____1ST COMMUNION____CONFIRMATION______</p><p>RACE (W-WHITE, AA AFRICAN AM., ORIENTAL, S-SPANISH ______FOREIGN LANGUAGE SPOKEN?______CHILDREN LIVING AT SAME ADDRESS</p><p>CHILD’S NAME______BIRTHDATE:______MALE OR FEMALE? Religious Education: Grade_____ Sacraments: Baptism Date______Church______1st Communion Date :______Church______Confirmation Date______Church______</p><p>CHILD’S NAME______BIRTHDATE:______MALE OR FEMALE? Religious Education: Grade______Sacraments: Baptism Date:______Church______1st Communion Date :______Church______Confirmation Date______Church______</p><p>CHILD’S NAME______BIRTHDATE:______MALE OR FEMALE? Religious Education: Grade______Sacraments: Baptism Date:______Church______1st Communion Date :______Church______Confirmation Date______Church______</p><p>CHILD’S NAME______BIRTHDATE:______MALE OR FEMALE? Religious Education: Grade______Sacraments: Baptism Date:______Church______1st Communion Date ______Church______Confirmation Date______Church______</p><p>Please use another sheet of paper if needed</p><p>OTHER ADULTS LIVING AT SAME ADDRESS (PARENTS/IN-LAWS/SIBLINGS) NAME:______BIRTHDATE______HOW RELATED______SPECIAL NEEDS (if any)______</p><p>How can we help you? Do you have any particular needs at this time, ie., Home-bound visits, nursing home visits, etc.</p><p>Would you like to share your talents/time with us? List of Ministries, please check what you are interested in or what you are currently doing: Catechist____Catechist Aid,___ RCIA,___ Altar Server-youth___, Church Choir___, Lector___, Eucharistic Minister___, or call the church and let us know how you would like to volunteer.</p><p>ST.DENNIS CHURCH P.O. BOX 249 GALENA, MD 21635 410-648-5145 e-mail: [email protected] web site: stdennischurch.org </p>