FOR OFFICE USE ONLY
1. Parish Number
____________________
Parish Census Data Sheet
Diocese of Superior – St. Bridget Parish
FAMILY NAME
FIRST NAME
2. Family Number
____________________
3. Member Number
____________________
4. Envelope Number ____________________
M.I.
5. Utility Codes
____________________
6. Date Registered
____________________
TITLE
(Mr, Ms, etc)
STREET ADDRESS
CITY
GENDER
M/F
STATE
HOME PHONE
EMPLOYER
MAIDEN NAME
HOUSEHOLD E-MAIL ADDRESS
DATE OF BIRTH
MO
Day
Yr
ZIP CODE
LAST NAME (If diff. than family name)
A
B
C
D
Marital Status
Race
Religion
Attendance at Mass
E
F
G
H
Highest Level of Education
Employment
Residence
Special Needs
Answer only if you are currently attending school
SACRAMENTAL RECORD
ANSWER “YES” IF THE SACREMENT HAS BEEN
RECEIVED OR “NO” IF IT HAS NOT
I
J
K
School
Grade
Attending Rel Ed
BAPTISM
(NAME AND ADDRESS OF THE CHURCH BAPTIZED AT)
(Y or N)
(Y or N)
I am interested in learning more about
St. Bridget School PreK-8 program.
I would like to receive the Catholic Herald
A Catholic newspaper sent out weekly for $20/yr
FIRST
RECONCILIATION
FIRST COMMUNION
CONFIRMATION
MATRIMONY
COMMENTS (Attach pages or write on back if needed):
INSTRUCTIONS FOR COMPLETING
PARISH CENSUS DATA SHEETS
Thank you for taking the time to complete the Parish Census Data Sheets. Please keep the following in mind
when completing your form(s):
1. Complete a Parish Census Data Sheet for each member of your household – regardless of their
religion or level of participation at our parish.
2. Use the code numbers from the Answer Code Sheet for categories A-K.
3. Complete the sacramental information in the “Sacramental Record” box.
Again, we thank you for completing this important information. You may return your completed form(s) to
the church office, Monday thru Friday, 8:30-4:30pm or email it to: recept@stbparish.com.
DIOCESE OF SUPERIOR
PARISH CENSUS DATA SHEET – ANSWER CODES
St. Bridget Parish
River Falls, Wisconsin
A) MARITAL STATUS
Which one response best represents your
marital status?
1. Single, never married
2. Valid marriage between two Catholics
3. Invalid marriage between two Catholics
4. Valid interfaith marriage
5. Invalid interfaith marriage
6. Separated
7. Divorced
8. Widowed
B) RACE
P1. White/Caucasian
P2. Black/African American
P3. American Indian & Alaskan Native
P4. Asian
P5. Hispanic
P6. Other (Please specify in comments)
C) RELIGION
1. Catholic
2. Assembly of God
3. Baptist
4. Congregational
5. Episcopalian
6. Four Square Gospel
7. Fundamentalist
8. Jehovah Witness
9. Jewish
A. Lutheran
B. Methodist
C. Mormon
D. Orthodox
E. Pentecostal
F. Presbyterian
G. Seventh Day Adventist
H. No religious affiliation
I. Other (Please specify in comments)
<OVER>
D) ATTENDANCE AT MASS
Which one response most accurately states
how frequently you attend Mass?
1. Daily attendance at mass
2. Weekly attendance at mass
3. Monthly attendance at mass
4. Quarterly attendance at mass
5. Annually or less
6. Seldom, if ever
E) HIGHEST LEVEL OF EDUCATION
Enter number for highest grade completed e.g.,
Senior Year High School – P26. Allow one
extra grade for each year of Vocational School
completed.
P15. Through Grade 1
P16. Through Grade 2
P17. Through Grade 3
P18. Through Grade 4
P19. Through Grade 5
P20. Through Grade 6
P21. Through Grade 7
P22. Through Grade 8
P23. Through Grade 9
P24. Through Grade 10
P25. Through Grade 11
P26. High School Graduate
P27. 1 Year Post Secondary
P28. 2 Year Post Secondary
P29. 3 Year Post Secondary
P30. 4 Year Post Secondary
P31. 5 Year Post Secondary
P32. 6 Year Post Secondary
P33. 7 Year Post Secondary
P34. 8 Year Post Secondary
P35. More than 8 years Post Secondary
F) EMPLOYMENT
Which of these positions best describes your
employment status? (Allow up to 3 responses:
most active first, least active last)
P50. Homemaker
P51. Manger/Proprietor
P52. Salesperson
P53. Professional
P54. Farmer
P55. Secretarial/Clerical
P56. Skilled Laborer
P57. Laborer
P58. Student
P59. Retired
P60. Unemployed
P61. Other (Please specify in comments)
G) RESIDENCE
Which one best states your residency in the
parish?
P40. Year around
P41. Less than a year, but 6 months or more
P42. Less then 6 months but reside in this
parish more than in any other parish.
P43. Summer Only
P44. Winter Only
P45. Other (Please specify in comments)
H) SPECIAL NEEDS
Do you have any special problems? (Allow up
to 3 responses, most problematic first)
P75. Walk with a cane
P76. Must use a walker
P77. Must use a wheelchair
P78. Need assistance walking
P79. Severe asthma
P80. Emphysema
P81. Developmental Disability
P82. Unsighted
P83. Deaf
P84. Stroke
P85. Shut in
P86. Other (Please specify in comments)
I) SCHOOL ATTENDING
1. Catholic Grade School (K-8)
2. Catholic High School (9-12)
3. Catholic College
4. Public Grade School (K-8)
5. Public High School (9-12)
6. Public College
7. Vocational School
8. Developmentally Disabled
9. Other (Please specify in comments)
A. Catholic Pre-School
B. Public Pre-School
J) GRADE
Enter number for present grade attending (Use
same instructions as given for section E)
K) ATENDING RELIGIOUS EDUCATION
G. Grade School
H. High School
C. Not applicable, attending Catholic School
N. Not applicable, already graduated from
high school
Comments: Could include:
1. Important items of information which the
census sheet did not include
2. “Other” response