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St. William Census/Registration Form
Please fill in the form below and be sure to "submit" at the end. Thank you!
Family Information
Family Name
*
Please enter last name of family.
Home Phone
*
If no home phone, your primary contact number
Home Address
*
Street Address
Street Address Line 2
City
State
Zip Code
Please Select
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American Samoa
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Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
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The Bahamas
Bahrain
Bangladesh
Barbados
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Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
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Germany
Ghana
Gibraltar
Greece
Greenland
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Guadeloupe
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Guinea
Guinea-Bissau
Guyana
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Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Parishioner Status
*
New Member
Existing Member
We are no longer parishioners
Previous Parish Name/City/State
For New Members
Mass most likely to attend (for Sunday Obligation)
Saturday 3:00 PM
Sunday 11:00 AM
Sunday 1:00 PM (Spanish Mass)
Mass Most likely to Attend at St. William (for Sunday Obligation). If "other" please list church name and time
Saturday 3:00 PM
Sunday 11:00 AM
Sunday 1:00 PM (Spanish Mass)
How often do you attend Mass?
Weekly
Bi-Monthly
Monthly
2 times year
Prefer not to answer
Other
Envelope Number
For current parishioners
Do you prefer to contribute to the parish through:
*
Weekly envelopes
ACH Electronic withdrawal weekly or monthly
Credit Card options available on Website
Other
Household Type:
Single Family
Single Adult
Single Parent
Widow/Widower
Blended Family
Extended Family (other adults living in the same household, adult children, elderly parents/relatives, relatives)
Other
Language(s) Spoken in the Home
*
Does anyone in the family have a disability?
Please list names and disability (ie: Autism, Downs Syndrome, wheelchair bound, etc.)
Is anyone in the home an alumni of St. William School? Please list name and year of graduation.
Please list name(s) and year of graduation.
Do you have any children aged 5-14?
*
Yes
No
If yes, are they registered/ing for PSR? (Parish School of Religion for the Region is held at St. Teresa of Avila on Sundays)
Yes
Contact Me
No
Please send me information on St. William School
Yes
No
Head of Household
Full Name
*
Mr.
Mrs.
Ms.
Dr.
Rev.
Dcn.
Br.
Sr.
Prefix
First Name
Middle Name
Last Name
Nickname
If applicable
Maiden Name
If applicable
Gender
Male
Female
Marital Status
*
Please Select
Married
Widowed
Separated
Divorced
Single
Married in the Catholic Church?
Yes
No
Church/Location Married in:
Name, City, State
Anniversary Date
/
Month
/
Day
Year
E-mail
*
If none, type none@none.com
Mobile Phone
Best Way(s) to Reach You
*
Home Phone
Mobile Phone
Email
Text to Mobile Phone
Occupation
If retired, prior primary occupation
Employer
Work Phone
Birth Date
*
/
Month
/
Day
Year
Mother's Maiden Name
Used to track Sacraments
Baptized?
*
Yes
No
As Catholic?
Yes
No
Church/Location of Baptism
Name, City, State
First Eucharist?
*
Yes
No
Church/Location of First Eucharist
Name, City, State
Confirmation?
*
Yes
No
Unkown
Church/Location of Confirmation
Name, City, State
RCIA?
Yes
No
Current Religion if not Catholic
Church/Location if participant in RCIA
Name, City, State
Spouse
Full Name
Mr.
Mrs.
Ms.
Dr.
Rev.
Prefix
First Name
Middle Name
Last Name
Nickname
If applicable
Maiden Name
If applicable
Gender
Male
Female
E-mail
Mobile Phone
Best Way(s) to Reach You
Home Phone
Mobile Phone
Email
Text to Mobile Phone
Occupation
If retired, prior primary occupation
Employer
Work Phone
Birth Date
/
Month
/
Day
Year
Mother's Maiden Name
Used to track Sacraments
Baptized?
Yes
No
As Catholic?
Yes
No
Church of Baptism/Location
Name, City, State
First Eucharist?
Yes
No
Church/Location of First Eucharist
Name, City, State
Confirmation?
Yes
No
Unkown
Church/Location of Confirmation
Name, City, State
RCIA?
Yes
No
Church/Location of if RCIA paricipant
Name, City, State
Current Religion (if not Catholic)
Children (Living at home)
Children over the age of 25 (or over age 25 and in a separate residence) should register with the parish on their own. This is essential for our ability to assist them with their sacramental needs or if they are asked to be a godparent, or sacramental sponsor. Other household members over the age of 25 should also register separately.
Child #1
Full Name
First Name
Middle Name
Last Name
Nickname
If applicable
Birth Date
/
Month
/
Day
Year
Gender
Male
Female
School
Please Select
St. William School
Covedale
Carson
Elder High School
Seton High School
West High
Oak Hills High School
Home-schooled
Other Catholic K-12 School
Other Cincinnati Public K-12 School
College
None
Year in School
Please Select
Pre-K 3
Pre-K 4
K
1
2
3
4
5
6
7
8
9
10
11
12
College
Baptized?
Yes
No
As Catholic?
Yes
No
Church/Location of Baptism
Name, City, State
First Reconciliation?
Yes
No
First Eucharist?
Yes
No
Church/Location of First Eucharist
Name, City, State
Confirmation?
Yes
No
Church/Location of Confirmation
Name, City, State
RCIA Participant?
Yes
No
Church/Location of RCIA Program
Name, City, State
Current Religion (if not Catholic)
Child #2
Full Name
First Name
Middle Name
Last Name
Nickname
If applicable
Birth Date
/
Month
/
Day
Year
Gender
Male
Female
Year in School
Please Select
Pre-K 3
Pre-K 4
K
1
2
3
4
5
6
7
8
9
10
11
12
College
School
Please Select
St. William School
Covedale
Carson
Elder High School
Seton High School
West High
Oak Hills High School
Home-schooled
Other Catholic K-12 School
Other Cincinnati K-12 School
College
None
Baptized?
Yes
No
As Catholic?
Yes
No
Church/Location of Baptism
Name, City, State
First Reconciliation?
Yes
No
First Eucharist?
Yes
No
Church/Location of First Eucharist
Name, City, State
Confirmation?
Yes
No
Church/Location of Confirmation
Name, City, State
RCIA Participant?
Yes
No
Church/Location of RCIA Program
Name, City, State
Current Religion (if not Catholic)
Child #3
Full Name
First Name
Middle Name
Last Name
Nickname
If applicable
Birth Date
/
Month
/
Day
Year
Gender
Male
Female
School
Please Select
St. William School
Covedale
Carson
Elder High School
Seton High School
West High
Oak Hills High School
Home-schooled
Other Catholic K-12 School
Other Cincinnati K-12 School
College
None
Year in School
Please Select
Pre-K 3
Pre-K 4
K
1
2
3
4
5
6
7
8
9
10
11
12
College
Baptized?
Yes
No
As Catholic?
Yes
No
Church of Baptism
Name, City, State
First Reconciliation?
Yes
No
First Eucharist?
Yes
No
Confirmation?
Yes
No
Church/Location of Confirmation
Name, City, State
RCIA?
Yes
No
Church/Location of RCIA Program
Name, City, State
Current Religion (if not Catholic)
Child #4
Full Name
First Name
Middle Name
Last Name
Nickname
If applicable
Birth Date
/
Month
/
Day
Year
Gender
Male
Female
School
Please Select
St. William School
Covedale
Carson
Elder High School
Seton High School
West High
Oak Hills High School
Home-schooled
Other Catholic K-12 School
Other Cincinnati K-12 School
College
None
Year in School
Please Select
Pre-K 3
Pre-K 4
K
1
2
3
4
5
6
7
8
9
10
11
12
College
Baptized?
Yes
No
As Catholic?
Yes
No
Church of Baptism
Name, City, State
First Reconciliation?
Yes
No
First Eucharist?
Yes
No
Confirmation?
Yes
No
Church/Location of Confirmation
Name, City, State
RCIA?
Yes
No
Church/Location of RCIA Program
Name, City, State
Current Religion (if not Catholic)
Child #5
Full Name
First Name
Middle Name
Last Name
Nickname
If applicable
Birth Date
/
Month
/
Day
Year
Gender
Male
Female
School
Please Select
St. William School
Covedale
Carson
Elder High School
Seton High School
West High
Oak Hills High School
Home-schooled
Other/College
None
Year in School
Please Select
Pre-K 3
Pre-K 4
K
1
2
3
4
5
6
7
8
9
10
11
12
College
Baptized?
Yes
No
As Catholic?
Yes
No
Church of Baptism
Name, City, State
First Reconciliation?
Yes
No
First Eucharist?
Yes
No
Confirmation?
Yes
No
Church/Location of Confirmation
Name, City, State
RCIA?
Yes
No
Church/Location of RCIA Program
Name, City, State
Current Religion (if not Catholic)
Child #6
Full Name
First Name
Full Middle Name
Last Name
Nickname
If applicable
Birthday
-
Month
-
Day
Year
Date
Gender
Male
Female
School
St. William School
Covedale
Carson
Elder High School
Seton High School
West High
Oak Hills High School
Home-schooled
Other/College
None
Year in School
Pre-K 3
Pre-K 4
K
1
2
3
4
5
6
7
8
9
10
11
12
College
Baptized?
Yes
No
As Catholic?
Yes
No
Church of Baptism:
Name, City, State
First Reconciliation?
Yes
No
First Eucharist?
Yes
No
Confirmation?
Yes
No
Unknown
Church/Location of Confirmation
Name, City, State
RCIA
Yes
No
Church/Location of RCIA Program
Name, City, State
Current Religion (if not Catholic)
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INVOLVEMENT IN THE CHURCH
Parish Outreach
Bereavement
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Communion to the Homebound
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Hispanic Ministry
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Hospital & Homebound Visits
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Respect Life Committee
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St. Vincent de Paul Society
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Liturgical Ministries
Altar Server (adult or youth)
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Eucharistic Minister
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Lector
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Mass Captain
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Adult Choir
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Young Adult Choir
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Usher/Greeter
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Organizations
Athletic Association
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Gardens & Grounds
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Education Commission (elected)
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Finance (appointed)
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Knights of Columbus
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Marthas & Matthews
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Pastoral Council (elected)
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Worship Commission
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Men's Prayer Group
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Wedding Sacristan and/or Assistant
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Religious Education
Marriage Preparation / FOCCUS
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PSR Instructor/Catechist
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RCIA Sponsor
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RCIA Volunteer
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Technology & Communications
Photography
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Bulletin Inserts
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Activities & Fundraising
Advent Luncheon (PTO Sponsored)
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Fish Fry
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Summer Festival
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Parish Picnic Committee/Volunteer
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School Volunteer (Virtus required)
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Parish Directory Authorizations
Publish Phone Number?
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Publish Address?
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Publish Email?
*
Yes
No
Add to list to receive EMAIL messages from parish?
*
Yes
No
Add to list to receive TEXT messages from parish?
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