Fillable parishioner-census-form.pdf
St. Mary’s Catholic Church of Piscataway Parishioner Census Update Form PLEASE PRINT AND FILL IN FULLY Completing this sheet will help us get to know our parish family better and will help update our parish records. Family Name____________________________________________________________________________ Mr.
Mrs.
Ms.
Miss
Envelope/Parishioner Number__________
Mr./Mrs.
Physical Address _________________________________________________________ City______________________________________ State______ Zip________-______ P.O. Box_________ Home Phone________________________________ Cell Phone____________________________ Unlisted Yes No MEMBER INFORMATION HEAD OF HOUSEHOLD Name___________________________________________________ Birthdate _____/______/______ Place_______________________________________ Last, First, Middle mm dd yyyy City, State Personal Cell phone________________________________________________ Work Phone____________________________________________________ E-mail__________________________________________________________________________________________________________________________ Male Female Religion/Denomination_____________________________________________ Church Attendance Frequency*__________________ Sacraments of Initiation: See bottom of page Baptism No Yes Date____/_____/______ Location___________________________________________________________________ 1st Eucharist Confirmation
Yes
No Yes
Location______________________________________________________________________________ No
Location______________________________________________________________________________
Church, City, State Marital Status Catholic Marriage Interfaith Marriage Civil Marriage Single Widowed Divorced Annulment Separated Marriage Date ______/_______/________ Location________________________________________________________________________________ mm dd yyyy Church, City, State Maiden Name (If Applicable)______________________________________________________ Occupation (Your Title)______________________________________________ Employer_____________________________________________________ Work phone_______________________________________________________ Work e-mail___________________________________________________ Education High School Some College Associates Degree Bachelors Degree Masters Degree Doctorate Degree Other________________ Ethnicity African-American Caucasian-American Hispanic-American Asian-American Native American Other_____________________ SPOUSE Name___________________________________________________ Birthdate _____/______/______ Place________________________________________ Last, First, Middle mm dd yyyy City, State Personal Cell phone_________________________________________________ Work Phone___________________________________________________ E-mail__________________________________________________________________________________________________________________________ Male Female Religion/Denomination_______________________________________________ Church Attendance Frequency*________________ Sacraments of Initiation: See bottom of page Baptism Yes No Location_____________________________________________________________________________ 1st Eucharist Yes No Location_____________________________________________________________________________ Confirmation Yes No Location_____________________________________________________________________________ Church, City, State Maiden Name (If Applicable)__________________________________________ Occupation (Your Title)_____________________________________________ Employer______________________________________________________ Work phone______________________________________________________ Work e-mail___________________________________________________ Education High School Some College Associates Degree Bachelors Degree Masters Degree Doctorate Degree Other_______________ Ethnicity African-American Caucasian-American Hispanic-American Asian-American Native American Other___________________ Activities, Ministries, Committees each family member belongs to: (Please, use a separate sheet of paper if you need more space) Name ______________________________________
_________________________________________________________________________________________________
Name______________________________________
_________________________________________________________________________________________________
Name______________________________________
_________________________________________________________________________________________________
*Church Attendance Frequency: D—Daily; M—More than weekly;
W—Weekly; F—Frequently; S—Seldom; N—Does not attend
List all dependents or others living at home [children (young and adult), grandchildren, siblings, older parents] Name________________________________________________________________________________________________
Male
Female
Last, First, Middle
Birthdate______/_______/________ Birthplace_____________________________________________________________________________________ MM/DD/YYYY
City, State
Education Grade (2016-2017)________ Name of School ______________________________________________ City, State_________________________________ Other Catholic School Christian (other Denomination) School Private School Public School Homeschool Attends Parish School of Religion (PSR) Yes No Sacraments of Initiation Baptism Yes No Location_____________________________________________________________________________________ 1st Eucharist Yes No Location_____________________________________________________________________________________ Confirmation Yes No Location_____________________________________________________________________________________ Name of Church , City, State
Activities and Volunteer Activities involved in: ______________________________________________________________________________________ _____________________________________________________________________________________________________________________________ Activities and Volunteer Activities you would like to become involved in:_________________________________________________________________ _____________________________________________________________________________________________________________________________ Name________________________________________________________________________________________________
Male Female
Last, First, Middle
Birthdate______/_______/________ Birthplace_____________________________________________________________________________________ MM/DD/YYYY
City, State
Education Grade (2016-2017)________ Name of School ______________________________________________ City, State_________________________________ Other Catholic School Christian (other Denomination) School Private School Public School Homeschool Attends Parish School of Religion (PSR) Yes No Sacraments of Initiation Baptism Yes No Location_____________________________________________________________________________________ 1st Eucharist Yes No Location_____________________________________________________________________________________ Confirmation Yes No Location_____________________________________________________________________________________ Name of Church , City, State
Activities and Volunteer Activities involved in: ______________________________________________________________________________________ _____________________________________________________________________________________________________________________________ Activities and Volunteer Activities you would like to become involved in:_________________________________________________________________ _____________________________________________________________________________________________________________________________ Name________________________________________________________________________________________________
Male Female
Last, First, Middle
Birthdate______/_______/________ Birthplace_____________________________________________________________________________________ MM/DD/YYYY
City, State
Education Grade (2016-2017)________ Name of School ______________________________________________ City, State_________________________________ Other Catholic School Christian (other Denomination) School Private School Public School Homeschool Attends Parish School of Religion (PSR) Yes No Sacraments of Initiation Baptism Yes No Location_____________________________________________________________________________________ 1st Eucharist Yes No Location_____________________________________________________________________________________ Confirmation Yes No Location_____________________________________________________________________________________ Name of Church , City, State
Activities and Volunteer Activities involved in: ______________________________________________________________________________________ _____________________________________________________________________________________________________________________________ Activities and Volunteer Activities you would like to become involved in:_________________________________________________________________ _____________________________________________________________________________________________________________________________
Mass Time you participate in:
Office Use Only Envelope Number#______________ Date Received_____/_____/______ By___________________________
Saturday 5:00 p.m.
Sunday 8:00 a.m.
Sunday 9:30 a.m.
Sunday 12 noon
It takes all of us to provide a community environment where people’s spiritual and emotional needs can be met as well as an environment where we all feel welcome to reach out and serve others, as well as being served. Please check out our Parish Website at http://www.saintmaryspiscataway.net where you can inquire about our Parish Ministries, Parish Committees, and to look at our bulletins and activities flyers. Facebook Page http://www.facebook.com/StMarysPiscataway for daily devotions, morning, noon and evening M-F.
Parish Activities (Please, highlight if interested in the following activities and print your name on the corresponding line) Building and Maintenance Committee ____________________________________
4. Royal Blue and Ivory School Gala ________
Parish Sponsored/Chartered/Cooperating _____________________________________ Organizations:
1. Adopt-a-Garden _____________________
Parish Organizations:
2. Carpentry __________________________
†
Cub Scouts ________________________
Bible Sharing ______________________ Boy Scouts ________________________
3. Computer IT ________________________
† Children’s Eucharistic Adoration______ Frontier Girls ______________________ 4. Electrical ___________________________ ____________________________________ Forestville Pregnancy Center † Eucharistic Adoration _______________ 5. Maintenance Work ___________________ _________________________________ 6. Painting ____________________________ † Holy Name Society__________________ Knights of Columbus ________________ 7. Parish Clean-up Day __________________
†
8. Plumbing ___________________________ 9. Other______________________________
†
Parish School of Religion (PSR) Cate Fall Soccer ________________________ chist/Aide ________________________ Spring Soccer ______________________ Parish School of Religion (PSR) Student _________________________________ Adult Softball Team ________________
Spirituality and Evangelization Committee † Adult Faith Formation Leaders _______ (S & E) ______________________________ _____________________________________ 1. Adoration/Daily Mass Promotion ________ † Rite of Christian Initiation for Adults 2. Rosary Relay for Priests _______________ (RCIA)____________________________ 3. Family Movie Night ___________________ † 4. Adult Faith Formation _________________ 5. Parish Prayer/study groups ____________
Sodality of Our Lady of Perpetual Help _________________________________
† Youth Ministry Adult Volunteers ______ _____________________________________
Any Special needs? Who? (example: Homebound, nursing home, blind, deaf, etc.) _____________________________________ _____________________________________ _____________________________________ I currently receive contribution envelopes Yes No
like to have implemented into our parish? Youth Ministry (Grades 7-12) _________ _____________________________________ _____________________________________ _____________________________________ History and Research Committee ________ Publicity Committee ___________________ _____________________________________ 1. Work on the history through research 1. Design materials for Community Outreach Skills and Talents: Please list all skills and about the history of St. Mary’s Piscataway ___________________________________ talents the each member of your family ____________________________________ have: 2. Publicize Parish/School Events __________ _____________________________________ Liturgy: 3. Share events with other parishes/ _____________________________________ 1. Altar Server _________________________ newspapers _________________________ _____________________________________ 2. Extra-ordinary Ministers of Holy St. Mary’s Church and School Association Communion _________________________ We (I) are registered parishioners and (C.S.A.) ______________________________ desire to continue as such. 4. Lector______________________________ 1. Help with unity of Church and School We (I) are not registered parishioners and 5. Nursing Home Mass Volunteer __________ ___________________________________ would like to register. 6. Parish Choir (Traditional)_______________ 2. Recruit more parish families into our Comments: 6. Community Evangelization Efforts † ___________________________________
School _____________________________ _____________________________________
7. Children’s Choir (Potential) _____________
_____________________________________ _____________________________________ _____________________________________
8. Cantors_____________________________ St. Vincent de Paul Society Committee 9. Usher ______________________________
Parish Activities Committee ____________ 1. Christmas Bazaar ____________________ 2. Parish Picnic ________________________ 3. Spaghetti Dinner _____________________
1.
Thank you for taking the time to fill out the Christmas/Thanksgiving Baskets ___________________________________ census form. As changes occur in your
2.
Deliver Food ________________________
3. 4.
family that affect the information you have provided on this form, please let us know, so that we may keep your records complete Help at the Food Pantry________________ and up-to-date. More room is on the back, if needed>>>> Advent Giving Tree ___________________
Mrs.
Ms.
Miss
Envelope/Parishioner Number__________
Mr./Mrs.
Physical Address _________________________________________________________ City______________________________________ State______ Zip________-______ P.O. Box_________ Home Phone________________________________ Cell Phone____________________________ Unlisted Yes No MEMBER INFORMATION HEAD OF HOUSEHOLD Name___________________________________________________ Birthdate _____/______/______ Place_______________________________________ Last, First, Middle mm dd yyyy City, State Personal Cell phone________________________________________________ Work Phone____________________________________________________ E-mail__________________________________________________________________________________________________________________________ Male Female Religion/Denomination_____________________________________________ Church Attendance Frequency*__________________ Sacraments of Initiation: See bottom of page Baptism No Yes Date____/_____/______ Location___________________________________________________________________ 1st Eucharist Confirmation
Yes
No Yes
Location______________________________________________________________________________ No
Location______________________________________________________________________________
Church, City, State Marital Status Catholic Marriage Interfaith Marriage Civil Marriage Single Widowed Divorced Annulment Separated Marriage Date ______/_______/________ Location________________________________________________________________________________ mm dd yyyy Church, City, State Maiden Name (If Applicable)______________________________________________________ Occupation (Your Title)______________________________________________ Employer_____________________________________________________ Work phone_______________________________________________________ Work e-mail___________________________________________________ Education High School Some College Associates Degree Bachelors Degree Masters Degree Doctorate Degree Other________________ Ethnicity African-American Caucasian-American Hispanic-American Asian-American Native American Other_____________________ SPOUSE Name___________________________________________________ Birthdate _____/______/______ Place________________________________________ Last, First, Middle mm dd yyyy City, State Personal Cell phone_________________________________________________ Work Phone___________________________________________________ E-mail__________________________________________________________________________________________________________________________ Male Female Religion/Denomination_______________________________________________ Church Attendance Frequency*________________ Sacraments of Initiation: See bottom of page Baptism Yes No Location_____________________________________________________________________________ 1st Eucharist Yes No Location_____________________________________________________________________________ Confirmation Yes No Location_____________________________________________________________________________ Church, City, State Maiden Name (If Applicable)__________________________________________ Occupation (Your Title)_____________________________________________ Employer______________________________________________________ Work phone______________________________________________________ Work e-mail___________________________________________________ Education High School Some College Associates Degree Bachelors Degree Masters Degree Doctorate Degree Other_______________ Ethnicity African-American Caucasian-American Hispanic-American Asian-American Native American Other___________________ Activities, Ministries, Committees each family member belongs to: (Please, use a separate sheet of paper if you need more space) Name ______________________________________
_________________________________________________________________________________________________
Name______________________________________
_________________________________________________________________________________________________
Name______________________________________
_________________________________________________________________________________________________
*Church Attendance Frequency: D—Daily; M—More than weekly;
W—Weekly; F—Frequently; S—Seldom; N—Does not attend
List all dependents or others living at home [children (young and adult), grandchildren, siblings, older parents] Name________________________________________________________________________________________________
Male
Female
Last, First, Middle
Birthdate______/_______/________ Birthplace_____________________________________________________________________________________ MM/DD/YYYY
City, State
Education Grade (2016-2017)________ Name of School ______________________________________________ City, State_________________________________ Other Catholic School Christian (other Denomination) School Private School Public School Homeschool Attends Parish School of Religion (PSR) Yes No Sacraments of Initiation Baptism Yes No Location_____________________________________________________________________________________ 1st Eucharist Yes No Location_____________________________________________________________________________________ Confirmation Yes No Location_____________________________________________________________________________________ Name of Church , City, State
Activities and Volunteer Activities involved in: ______________________________________________________________________________________ _____________________________________________________________________________________________________________________________ Activities and Volunteer Activities you would like to become involved in:_________________________________________________________________ _____________________________________________________________________________________________________________________________ Name________________________________________________________________________________________________
Male Female
Last, First, Middle
Birthdate______/_______/________ Birthplace_____________________________________________________________________________________ MM/DD/YYYY
City, State
Education Grade (2016-2017)________ Name of School ______________________________________________ City, State_________________________________ Other Catholic School Christian (other Denomination) School Private School Public School Homeschool Attends Parish School of Religion (PSR) Yes No Sacraments of Initiation Baptism Yes No Location_____________________________________________________________________________________ 1st Eucharist Yes No Location_____________________________________________________________________________________ Confirmation Yes No Location_____________________________________________________________________________________ Name of Church , City, State
Activities and Volunteer Activities involved in: ______________________________________________________________________________________ _____________________________________________________________________________________________________________________________ Activities and Volunteer Activities you would like to become involved in:_________________________________________________________________ _____________________________________________________________________________________________________________________________ Name________________________________________________________________________________________________
Male Female
Last, First, Middle
Birthdate______/_______/________ Birthplace_____________________________________________________________________________________ MM/DD/YYYY
City, State
Education Grade (2016-2017)________ Name of School ______________________________________________ City, State_________________________________ Other Catholic School Christian (other Denomination) School Private School Public School Homeschool Attends Parish School of Religion (PSR) Yes No Sacraments of Initiation Baptism Yes No Location_____________________________________________________________________________________ 1st Eucharist Yes No Location_____________________________________________________________________________________ Confirmation Yes No Location_____________________________________________________________________________________ Name of Church , City, State
Activities and Volunteer Activities involved in: ______________________________________________________________________________________ _____________________________________________________________________________________________________________________________ Activities and Volunteer Activities you would like to become involved in:_________________________________________________________________ _____________________________________________________________________________________________________________________________
Mass Time you participate in:
Office Use Only Envelope Number#______________ Date Received_____/_____/______ By___________________________
Saturday 5:00 p.m.
Sunday 8:00 a.m.
Sunday 9:30 a.m.
Sunday 12 noon
It takes all of us to provide a community environment where people’s spiritual and emotional needs can be met as well as an environment where we all feel welcome to reach out and serve others, as well as being served. Please check out our Parish Website at http://www.saintmaryspiscataway.net where you can inquire about our Parish Ministries, Parish Committees, and to look at our bulletins and activities flyers. Facebook Page http://www.facebook.com/StMarysPiscataway for daily devotions, morning, noon and evening M-F.
Parish Activities (Please, highlight if interested in the following activities and print your name on the corresponding line) Building and Maintenance Committee ____________________________________
4. Royal Blue and Ivory School Gala ________
Parish Sponsored/Chartered/Cooperating _____________________________________ Organizations:
1. Adopt-a-Garden _____________________
Parish Organizations:
2. Carpentry __________________________
†
Cub Scouts ________________________
Bible Sharing ______________________ Boy Scouts ________________________
3. Computer IT ________________________
† Children’s Eucharistic Adoration______ Frontier Girls ______________________ 4. Electrical ___________________________ ____________________________________ Forestville Pregnancy Center † Eucharistic Adoration _______________ 5. Maintenance Work ___________________ _________________________________ 6. Painting ____________________________ † Holy Name Society__________________ Knights of Columbus ________________ 7. Parish Clean-up Day __________________
†
8. Plumbing ___________________________ 9. Other______________________________
†
Parish School of Religion (PSR) Cate Fall Soccer ________________________ chist/Aide ________________________ Spring Soccer ______________________ Parish School of Religion (PSR) Student _________________________________ Adult Softball Team ________________
Spirituality and Evangelization Committee † Adult Faith Formation Leaders _______ (S & E) ______________________________ _____________________________________ 1. Adoration/Daily Mass Promotion ________ † Rite of Christian Initiation for Adults 2. Rosary Relay for Priests _______________ (RCIA)____________________________ 3. Family Movie Night ___________________ † 4. Adult Faith Formation _________________ 5. Parish Prayer/study groups ____________
Sodality of Our Lady of Perpetual Help _________________________________
† Youth Ministry Adult Volunteers ______ _____________________________________
Any Special needs? Who? (example: Homebound, nursing home, blind, deaf, etc.) _____________________________________ _____________________________________ _____________________________________ I currently receive contribution envelopes Yes No
like to have implemented into our parish? Youth Ministry (Grades 7-12) _________ _____________________________________ _____________________________________ _____________________________________ History and Research Committee ________ Publicity Committee ___________________ _____________________________________ 1. Work on the history through research 1. Design materials for Community Outreach Skills and Talents: Please list all skills and about the history of St. Mary’s Piscataway ___________________________________ talents the each member of your family ____________________________________ have: 2. Publicize Parish/School Events __________ _____________________________________ Liturgy: 3. Share events with other parishes/ _____________________________________ 1. Altar Server _________________________ newspapers _________________________ _____________________________________ 2. Extra-ordinary Ministers of Holy St. Mary’s Church and School Association Communion _________________________ We (I) are registered parishioners and (C.S.A.) ______________________________ desire to continue as such. 4. Lector______________________________ 1. Help with unity of Church and School We (I) are not registered parishioners and 5. Nursing Home Mass Volunteer __________ ___________________________________ would like to register. 6. Parish Choir (Traditional)_______________ 2. Recruit more parish families into our Comments: 6. Community Evangelization Efforts † ___________________________________
School _____________________________ _____________________________________
7. Children’s Choir (Potential) _____________
_____________________________________ _____________________________________ _____________________________________
8. Cantors_____________________________ St. Vincent de Paul Society Committee 9. Usher ______________________________
Parish Activities Committee ____________ 1. Christmas Bazaar ____________________ 2. Parish Picnic ________________________ 3. Spaghetti Dinner _____________________
1.
Thank you for taking the time to fill out the Christmas/Thanksgiving Baskets ___________________________________ census form. As changes occur in your
2.
Deliver Food ________________________
3. 4.
family that affect the information you have provided on this form, please let us know, so that we may keep your records complete Help at the Food Pantry________________ and up-to-date. More room is on the back, if needed>>>> Advent Giving Tree ___________________
