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Please list all children under the age of 21 at home or away at school. Any son or daughter who has reached the age of 21, or has completed formal schooling and is now employed, is to have his/her own census form (even if living at the same address).

Please advise us if there are others in your household who are homebound and in need of special ministry or Communion calls. They are welcome to be registered as a part of your household, or to register separately in their own name.

An empty text box has been inserted at the bottom of the registration form so that you can let us know of any special circumstances (i.e. if someone is homebound and is in need of communion on Sunday).

The maximum number of form submissions has been reached. This form is currently not available.
- Family Name REQUIRED Please fill out this field. Please enter valid data.
- Address REQUIRED Please fill out this field. Please enter valid data.
- Apartment / Unit Number Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Head of Household
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Maiden Name Please enter valid data.
- Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Cell Phone Number Please enter a phone number.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Birth Date REQUIRED Please fill out this field. Please enter valid data.
- Marriage Status REQUIRED Please fill out this field.
- Date and Place of Marriage (if applicable) Please enter valid data.
- Gender Male Female
- Religion REQUIRED Please fill out this field.
- Baptized Yes No
- Communion? Yes No
- Confirmation? Yes No
- Occupation/Profession Please enter valid data.
- Other Member of Household
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Birth Date Please enter valid data.
  
  Cell Phone Number Please enter a phone number.
  
  Email Please enter an email address.
  
  Gender Male Female
  
  Relationship to Head of Household
  
  Maiden Name Please enter valid data.
  
  Occupation/Profession Please enter valid data.
  
  Religion
  
  Baptized? Yes No
  
  Communion? Yes No
  
  Confirmation? Yes No
- Other Member of Household
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Birth Date Please enter valid data.
  
  Cell Phone Number Please enter a phone number.
  
  Email Please enter an email address.
  
  Gender Male Female
  
  Relationship to Head of Household
  
  Religion
  
  Baptized? Yes No
  
  Communion? Yes No
  
  Confirmation? Yes No
- Other Member of Household
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Cell Phone Number Please enter a phone number.
  
  Email Please enter an email address.
  
  Birth Date Please enter valid data.
  
  Gender Male Female
  
  Relationship to Head of Household
  
  Religion
  
  Baptized? Yes No
  
  Communion? Yes No
  
  Confirmation? Yes No
- Notes
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The Cathedral of Saint John the Evangelist

Cleveland, Ohio

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