DIOCESE OF WILMINGTON CENSUS PARISHIONER NUMBER

DIOCESE OF WILMINGTON CENSUS
PARISHIONER NUMBER _____________________________
(OFFICE USE ONLY)
Family Name (Apellido Familiar) __________________________________________________________________________________________
House No. (Numero de Casa) ___________ Street (Calle) ______________________________________________________________________
City (Ciudad) _________________________State (Estado) ___________________________________________Zip (C.P.) __________________
Parish Registered (Parroquia Registrada) ___________________________________________________________________________________
Parish Attending (Parroquia a que Asiste) ___________________________________________________________________________________
Telephone Number (Telephono)___________________________________________________________________________________________
A. Husband and Wife (Esposo y Esposa):
Name
Status
Date of Birth
Nombre
Estado Civil
Fecha de
nacimeinto
B.
Baptized
Bautizado
Catholic
Catolico
Y or N
1st Comm.
Primera
Comunion
Confirmed
Confirmado
Rec Rel. Ed
Recibe
Educacion
Religosa
Occupation
Ocupacion
Other
Children living in the house from oldest to youngest (Ninos viviendo en casa de mayor al menor)
Do you wish to receive the Dialog?
Yes
No
Desea recibir el periodico diocesano?
Si
No
If you are not receiving parish support envelopes, do you wish to receive them?
Le gustaria recibir en su hogar sobres para la ofrenda seminal?
Yes
Si
No
No
Other Adults living at this address? Otros adultos que viven en esta direccion y son parte de la familia?
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