St. Andrew Parish & School

St. Andrew Parish Census

Thank you for filling out our parish census. There are four sections: Family Information, Preferences, Skills & Needs, and Comments/Questions. Depending on the size of your family, it should probably not take more than 15 minutes to complete. We are not asking for anything you likely wouldn't know off the top of your head. 

Please list all family members in your household and associated questions. All information provided is for parish use only; no information will be sold or shared with organizations outside of St. Andrew Parish. It is strictly for parish communications. If you have any questions, you can speak to Father Jim Schuerman, Pastor, 262-728-5922 or Shari Loback, Parish Council Census Coordinator, 262-374-0705.

St. Andrew Parish Census 2012:

SECTION 1: FAMILY INFORMATION
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Family Surname (Last Name):

PRIMARY ADDRESS
*

Street: 
*

City:
*

ZIP Code:
*

Phone Number (With Area Code and without dashes):

Alternate Phone Number: 
*

Current Family Type (please check or add anything not listed that best describes your family):
Two parent family with minor children   One parent family with minor children   Two or more adults residing at same address   Family with adult children   Individual residing alone   Married couple with no children at home   Multi-generational family   Other (Please describe in next question)

Other Family Type not listed:

FAMILY MEMBER #1 (HEAD OF HOUSEHOLD)
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Name:
*

Sex:
Male   Female
*

Date of Birth (MM/DD/YYYY):
*

Marital Status:
*

Are You Catholic?
Yes   No

If no, what religion:
*

Have you been baptized?
Yes   No
Don't Know
*

Have you had 1st Reconciliation?
Yes   No
Don't Know
*

Have you had 1st Communion?
Yes   No
Don't Know
*

Have you been confirmed?
Yes   No
Don't Know

FAMILY MEMBER #2

Name:

Sex:
Male   Female

Date of Birth (MM/DD/YYYY):

Marital Status:

Relation to Head of Household (spouse, child, parent, aunt, etc.):

Catholic?
Yes   No

If not Catholic, religion:

Baptized?
Yes   No
Don't Know

1st Reconciliation?
Yes   No
Don't Know

1st Communion?
Yes   No
Don't Know

Confirmed?
Yes   No
Don't Know

FAMILY MEMBER #3

Name:

Sex:
Male   Female

Date of Birth (MM/DD/YYYY):

Marital Status:

Relation to Head of Household (spouse, child, parent, aunt, etc.):

Catholic?
Yes   No

If not Catholic, religion:

Baptized?
Yes   No
Don't Know

1st Reconciliation?
Yes   No
Don't Know

1st Communion?
Yes   No
Don't Know

Confirmed?
Yes   No
Don't Know

FAMILY MEMBER #4

Name:

Sex:
Male   Female

Date of Birth (MM/DD/YYYY):

Marital Status:

Relation to Head of Household (spouse, child, parent, aunt, etc.):

Catholic?
Yes   No

If not Catholic, religion:

Baptized?
Yes   No
Don't Know

1st Reconciliation?
Yes   No
Don't Know

1st Communion?
Yes   No
Don't Know

Confirmed?
Yes   No
Don't Know

FAMILY MEMBER #5

Name:

Sex:
Male   Female

Date of Birth (MM/DD/YYYY):

Marital Status:

Relation to Head of Household (spouse, child, parent, aunt, etc.):

Catholic?
Yes   No
Don't Know

If not Catholic, religion:

Baptized?
Yes   No
Don't Know

1st Reconciliation?
Yes   No
Don't Know

1st Communion?
Yes   No
Don't Know

Confirmed?
Yes   No
Don't Know

FAMILY MEMBER #6

Name:

Sex:
Male   Female

Date of Birth (MM/DD/YYYY):

Marital Status:

Relation to Head of Household (spouse, child, parent, aunt, etc.):

Catholic?
Yes   No

If not Catholic, religion:

Baptized?
Yes   No
Don't Know

1st Reconciliation?
Yes   No
Don't Know

1st Communion?
Yes   No
Don't Know

Confirmed?
Yes   No
Don't Know

FAMILY MEMBER #7

Name:

Sex:
Male   Female

Date of Birth (MM/DD/YYYY):

Marital Status:

Relation to Head of Household (spouse, child, parent, aunt, etc.):

Catholic?
Yes   No

If not Catholic, religion:

Baptized?
Yes   No
Don't Know

1st Reconciliation?
Yes   No
Don't Know

1st Communion?
Yes   No
Don't Know

Confirmed?
Yes   No
Don't Know

FAMILY MEMBER #8

Name:

Sex:
Male   Female

Date of Birth (MM/DD/YYYY):

Marital Status:

Relation to Head of Household (spouse, child, parent, aunt, etc.):

Catholic?
Yes   No

If not Catholic, religion:

Baptized?
Yes   No
Don't Know

1st Reconciliation?
Yes   No
Don't Know

1st Communion?
Yes   No
Don't Know

Confirmed?
Yes   No
Don't Know

If you need to add additional family members beyond #8, please use the box below to add the members with the same data for each asked above for each member. Thank you!

SECTION 2: PREFERENCES
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1. St. Andrew Parish would like to publish birthdays (minus year) for each month in the parish bulletin. Do we have your permission to publish your family’s names in the birthday list?
Yes   No
*

2.  If you are married, would you share your anniversary date with us and allow us to put your anniversary in the bulletin? 
Yes   No

2a. If yes, please provide wedding anniversary date:
*

3. Are you a currently a registered member/family of St. Andrew Parish?
Yes   No   Don't Know
*

3a. If no, or don’t know, would you like us to register you via this census form?
Yes   No
Not Applicable
*

3b. Are you registered at any other parish or church?
Yes   No

3c. If yes, name of other parish:
*

4. Do you currently receive envelopes from St. Andrew Parish?
Yes   No

4a. If yes, what is your envelope number?
*

5. Would you rather receive e-mails or regular mail from St. Andrew Parish concerning parish communications?
E-mail   U.S. Mail
*

6. Do you prefer to go to one specific Mass time?
Yes   No

6a. If yes, what time do you prefer and why?
*

7. Do you have family members who wish to receive communion at home?
Yes   No
*

8. Do you have family members with special needs that we may be able to help with or need help at Mass, parish functions, etc?
Yes   No

9. Do you have any ideas on how to make St. Andrew Parish a more welcoming community? Please leave them below.

10. Do you have any concerns/questions about St. Andrew Parish? Please comment.
*

11. Preferred language spoken at home:

 (1 required)
English   Spanish
ASL   Other

SECTION 3: NEEDS & SKILLS

Below are questions to determine the skills and needs of our parishioners. Often times, people have and want to help but do not know how to find the person/people who need that help. The church can become a very important intermediary in helping those people find each other. We cannot guarantee that all needs will be met, but by filling out this form and turning it in will give us a chance to try and make this match.

Do you have any needs listed below?
Babysitting   Cleaning   Cooking/Baking   Eldercare   Eucharist at Home
Food Assistance   General Maintenance   Snow Removal   Transportation to Church   Transportation other places
Visit nursing home   Visit from fellow parishioners   Yardwork

 

Do you have any skills you'd like to offer for those in need listed below?
Arts & Crafts   Assist with Short-term projects   Babysitting   Cleaning   Cooking/Baking
Eldercare   Eucharist at Home   Food Assistance   General Maintenance   Music: vocal
Music: Instrumental   Photography   Sewing   Snow Removal   Spiritual Growth Events
Visit fellow parishioners   Prayer Chain   Transportation   Yard Work   Greeting at Mass

SECTION 4: COMMENTS/QUESTIONS

Please leave any additional comments or questions here. If you need to add any information for a certain question, please include the question number, if applicable.
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Name of person filling out census form:

* Enter Your Email Address:

Type in the text that you see above: