Census 2024

The Holy Rood Collaborative
Home to St. Mary, St. John the Evangelist, and St. Margaret of Scotland Parish Families

Any and all information provided to us through this census will remain confidential and will not be shared with any party other than staff and clergy of The Holy Rood Collaborative.

_______________________________________________________________________________

** FOR OFFICE USE ONLY **
Please do NOT enter anything here!
Begin at **FORM BEGINS HERE**

RECEIVED ON: Please enter valid data.

DATE ENTERED: Please enter valid data.

** FORM BEGINS HERE **

FAMILY LAST NAME REQUIRED Please fill out this field. Please enter valid data.

FAMILY STREET ADDRESS REQUIRED Please fill out this field. 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.

FAMILY MAILING ADDRESS (if different) Please enter valid data.

City Please enter valid data.

State

Zip Please enter a zip code.

PRIMARY PHONE NUMBER REQUIRED

please enter with dashes, ex xxx-xxx-xxxx

Please fill out this field. Please enter a phone number.

CELL or LANDLINE? REQUIRED cell landline Please fill out this field.

If you do not have an email, please enter [email protected]

PRIMARY EMAIL (used for communications puposes) REQUIRED

If you do not have an email, please enter [email protected]

Please fill out this field. Please enter an email address.

WHICH PARISH IS YOUR FAMILY REGISTERED IN? REQUIRED St. Mary St. Margaret of Scotland St. John the Evangelist I am not sure Please fill out this field.

CHECK ONE OF THE BELOW REQUIRED I/we wish to remain registered in the above selected parish I/we wish to unregister from the above selected parish Please fill out this field.

For any member who is a minor, please feel free to enter parent's email and cell phone number. If there is no family email, please enter [email protected].

NUMBER OF MEMBERS IN HOUSEHOLD REQUIRED Please fill out this field.
HOUSEHOLD MEMBER 1
- MEMBER FIRST NAME REQUIRED Please fill out this field. Please enter valid data.
- MEMBER MIDDLE NAME Please enter valid data.
- MEMBER LAST NAME REQUIRED Please fill out this field. Please enter valid data.
- MEMBER ROLE REQUIRED single; head of household husband wife son daughter other Please fill out this field.
- IF OTHER, WHAT IS YOUR ROLE? Please enter valid data.
- MEMBER MARITAL STATUS REQUIRED single married widowed separated divorced annulled Please fill out this field.
- MEMBER PHONE NUMBER REQUIRED Maximum 20 characters
  please enter phone number with appropriate dashes, ex. xxx-xxx-xxxx.
  Please fill out this field. Please enter a phone number.
- CELL or LANDLINE? REQUIRED cell landline Please fill out this field.
- MEMBER EMAIL REQUIRED Please fill out this field. Please enter an email address.
- MEMBER DATE OF BIRTH REQUIRED
  enter as 2 digit month/ 2 digit day/ 4 digit year
  Please fill out this field. Please enter valid data.
- MEMBER RELIGION? REQUIRED Please fill out this field. Please enter valid data.
- MEMBER OCCUPATION? REQUIRED Please fill out this field. Please enter valid data.
HOUSEHOLD MEMBER 2
- MEMBER FIRST NAME REQUIRED Please fill out this field. Please enter valid data.
- MEMBER MIDDLE NAME Please enter valid data.
- MEMBER LAST NAME REQUIRED Please fill out this field. Please enter valid data.
- MEMBER ROLE REQUIRED single; head of household husband wife son daughter other Please fill out this field.
- IF OTHER, WHAT IS YOUR ROLE? Please enter valid data.
- MEMBER MARITAL STATUS REQUIRED single married widowed separated divorced annulled Please fill out this field.
- MEMBER PHONE NUMBER REQUIRED Maximum 20 characters
  please enter phone number with appropriate dashes, ex. xxx-xxx-xxxx.
  Please fill out this field. Please enter a phone number.
- CELL or LANDLINE? REQUIRED cell landline Please fill out this field.
- MEMBER EMAIL REQUIRED Please fill out this field. Please enter an email address.
- MEMBER DATE OF BIRTH REQUIRED
  enter as 2 digit month/ 2 digit day/ 4 digit year
  Please fill out this field. Please enter valid data.
- MEMBER RELIGION? REQUIRED Please fill out this field. Please enter valid data.
- MEMBER OCCUPATION? REQUIRED Please fill out this field. Please enter valid data.
HOUSEHOLD MEMBER 3
- MEMBER FIRST NAME REQUIRED Please fill out this field. Please enter valid data.
- MEMBER MIDDLE NAME Please enter valid data.
- MEMBER LAST NAME REQUIRED Please fill out this field. Please enter valid data.
- MEMBER ROLE REQUIRED single; head of household husband wife son daughter other Please fill out this field.
- IF OTHER, WHAT IS YOUR ROLE? Please enter valid data.
- MEMBER MARITAL STATUS REQUIRED single married widowed separated divorced annulled Please fill out this field.
- MEMBER PHONE NUMBER REQUIRED Maximum 20 characters
  please enter phone number with appropriate dashes, ex. xxx-xxx-xxxx.
  Please fill out this field. Please enter a phone number.
- CELL or LANDLINE? REQUIRED cell landline Please fill out this field.
- MEMBER EMAIL REQUIRED Please fill out this field. Please enter an email address.
- MEMBER DATE OF BIRTH REQUIRED
  enter as 2 digit month/ 2 digit day/ 4 digit year
  Please fill out this field. Please enter valid data.
- MEMBER RELIGION? REQUIRED Please fill out this field. Please enter valid data.
- MEMBER OCCUPATION? REQUIRED Please fill out this field. Please enter valid data.
HOUSEHOLD MEMBER 4
- MEMBER FIRST NAME REQUIRED Please fill out this field. Please enter valid data.
- MEMBER MIDDLE NAME Please enter valid data.
- MEMBER LAST NAME REQUIRED Please fill out this field. Please enter valid data.
- MEMBER ROLE REQUIRED single; head of household husband wife son daughter other Please fill out this field.
- IF OTHER, WHAT IS YOUR ROLE? Please enter valid data.
- MEMBER MARITAL STATUS REQUIRED single married widowed separated divorced annulled Please fill out this field.
- MEMBER PHONE NUMBER REQUIRED Maximum 20 characters
  please enter phone number with appropriate dashes, ex. xxx-xxx-xxxx.
  Please fill out this field. Please enter a phone number.
- CELL or LANDLINE? REQUIRED cell landline Please fill out this field.
- MEMBER EMAIL REQUIRED Please fill out this field. Please enter an email address.
- MEMBER DATE OF BIRTH REQUIRED
  enter as 2 digit month/ 2 digit day/ 4 digit year
  Please fill out this field. Please enter valid data.
- MEMBER RELIGION? REQUIRED Please fill out this field. Please enter valid data.
- MEMBER OCCUPATION? REQUIRED Please fill out this field. Please enter valid data.
HOUSEHOLD MEMBER 5
- MEMBER FIRST NAME REQUIRED Please fill out this field. Please enter valid data.
- MEMBER MIDDLE NAME Please enter valid data.
- MEMBER LAST NAME REQUIRED Please fill out this field. Please enter valid data.
- MEMBER ROLE REQUIRED single; head of household husband wife son daughter other Please fill out this field.
- IF OTHER, WHAT IS YOUR ROLE? Please enter valid data.
- MEMBER MARITAL STATUS REQUIRED single married widowed separated divorced annulled Please fill out this field.
- MEMBER PHONE NUMBER REQUIRED Maximum 20 characters
  please enter phone number with appropriate dashes, ex. xxx-xxx-xxxx.
  Please fill out this field. Please enter a phone number.
- CELL or LANDLINE? REQUIRED cell landline Please fill out this field.
- MEMBER EMAIL REQUIRED Please fill out this field. Please enter an email address.
- MEMBER DATE OF BIRTH REQUIRED
  enter as 2 digit month/ 2 digit day/ 4 digit year
  Please fill out this field. Please enter valid data.
- MEMBER RELIGION? REQUIRED Please fill out this field. Please enter valid data.
- MEMBER OCCUPATION? REQUIRED Please fill out this field. Please enter valid data.
HOUSEHOLD MEMBER 6
- MEMBER FIRST NAME REQUIRED Please fill out this field. Please enter valid data.
- MEMBER MIDDLE NAME Please enter valid data.
- MEMBER LAST NAME REQUIRED Please fill out this field. Please enter valid data.
- MEMBER ROLE REQUIRED single; head of household husband wife son daughter other Please fill out this field.
- IF OTHER, WHAT IS YOUR ROLE? Please enter valid data.
- MEMBER MARITAL STATUS REQUIRED single married widowed separated divorced annulled Please fill out this field.
- MEMBER PHONE NUMBER REQUIRED Maximum 20 characters
  please enter phone number with appropriate dashes, ex. xxx-xxx-xxxx.
  Please fill out this field. Please enter a phone number.
- CELL or LANDLINE? REQUIRED cell landline Please fill out this field.
- MEMBER EMAIL REQUIRED Please fill out this field. Please enter an email address.
- MEMBER DATE OF BIRTH REQUIRED
  enter as 2 digit month/ 2 digit day/ 4 digit year
  Please fill out this field. Please enter valid data.
- MEMBER RELIGION? REQUIRED Please fill out this field. Please enter valid data.
- MEMBER OCCUPATION? REQUIRED Please fill out this field. Please enter valid data.
HOUSEHOLD MEMBER 7
- MEMBER FIRST NAME REQUIRED Please fill out this field. Please enter valid data.
- MEMBER MIDDLE NAME Please enter valid data.
- MEMBER LAST NAME REQUIRED Please fill out this field. Please enter valid data.
- MEMBER ROLE REQUIRED single; head of household husband wife son daughter other Please fill out this field.
- IF OTHER, WHAT IS YOUR ROLE? Please enter valid data.
- MEMBER MARITAL STATUS REQUIRED single married widowed separated divorced annulled Please fill out this field.
- MEMBER PHONE NUMBER REQUIRED Maximum 20 characters
  please enter phone number with appropriate dashes, ex. xxx-xxx-xxxx.
  Please fill out this field. Please enter a phone number.
- CELL or LANDLINE? REQUIRED cell landline Please fill out this field.
- MEMBER EMAIL REQUIRED Please fill out this field. Please enter an email address.
- MEMBER DATE OF BIRTH REQUIRED
  enter as 2 digit month/ 2 digit day/ 4 digit year
  Please fill out this field. Please enter valid data.
- MEMBER RELIGION? REQUIRED Please fill out this field. Please enter valid data.
- MEMBER OCCUPATION? REQUIRED Please fill out this field. Please enter valid data.
HOUSEHOLD MEMBER 8
- MEMBER FIRST NAME REQUIRED Please fill out this field. Please enter valid data.
- MEMBER MIDDLE NAME Please enter valid data.
- MEMBER LAST NAME REQUIRED Please fill out this field. Please enter valid data.
- MEMBER ROLE REQUIRED single; head of household husband wife son daughter other Please fill out this field.
- IF OTHER, WHAT IS YOUR ROLE? Please enter valid data.
- MEMBER MARITAL STATUS REQUIRED single married widowed separated divorced annulled Please fill out this field.
- MEMBER PHONE NUMBER REQUIRED Maximum 20 characters
  please enter phone number with appropriate dashes, ex. xxx-xxx-xxxx.
  Please fill out this field. Please enter a phone number.
- CELL or LANDLINE? REQUIRED cell landline Please fill out this field.
- MEMBER EMAIL REQUIRED Please fill out this field. Please enter an email address.
- MEMBER DATE OF BIRTH REQUIRED
  enter as 2 digit month/ 2 digit day/ 4 digit year
  Please fill out this field. Please enter valid data.
- MEMBER RELIGION? REQUIRED Please fill out this field. Please enter valid data.
- MEMBER OCCUPATION? REQUIRED Please fill out this field. Please enter valid data.
HOUSEHOLD MEMBER 9
- MEMBER FIRST NAME REQUIRED Please fill out this field. Please enter valid data.
- MEMBER MIDDLE NAME Please enter valid data.
- MEMBER LAST NAME REQUIRED Please fill out this field. Please enter valid data.
- MEMBER ROLE REQUIRED single; head of household husband wife son daughter other Please fill out this field.
- IF OTHER, WHAT IS YOUR ROLE? Please enter valid data.
- MEMBER MARITAL STATUS REQUIRED single married widowed separated divorced annulled Please fill out this field.
- MEMBER PHONE NUMBER REQUIRED Maximum 20 characters
  please enter phone number with appropriate dashes, ex. xxx-xxx-xxxx.
  Please fill out this field. Please enter a phone number.
- CELL or LANDLINE? REQUIRED cell landline Please fill out this field.
- MEMBER EMAIL REQUIRED Please fill out this field. Please enter an email address.
- MEMBER DATE OF BIRTH REQUIRED
  enter as 2 digit month/ 2 digit day/ 4 digit year
  Please fill out this field. Please enter valid data.
- MEMBER RELIGION? REQUIRED Please fill out this field. Please enter valid data.
- MEMBER OCCUPATION? REQUIRED Please fill out this field. Please enter valid data.
HOUSEHOLD MEMBER 10
- MEMBER FIRST NAME REQUIRED Please fill out this field. Please enter valid data.
- MEMBER MIDDLE NAME Please enter valid data.
- MEMBER LAST NAME REQUIRED Please fill out this field. Please enter valid data.
- MEMBER ROLE REQUIRED single; head of household husband wife son daughter other Please fill out this field.
- IF OTHER, WHAT IS YOUR ROLE? Please enter valid data.
- MEMBER MARITAL STATUS REQUIRED single married widowed separated divorced annulled Please fill out this field.
- MEMBER PHONE NUMBER REQUIRED Maximum 20 characters
  please enter phone number with appropriate dashes, ex. xxx-xxx-xxxx.
  Please fill out this field. Please enter a phone number.
- CELL or LANDLINE? REQUIRED cell landline Please fill out this field.
- MEMBER EMAIL REQUIRED Please fill out this field. Please enter an email address.
- MEMBER DATE OF BIRTH REQUIRED
  enter as 2 digit month/ 2 digit day/ 4 digit year
  Please fill out this field. Please enter valid data.
- MEMBER RELIGION? REQUIRED Please fill out this field. Please enter valid data.
- MEMBER OCCUPATION? REQUIRED Please fill out this field. Please enter valid data.