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St. John the Baptist Orthodox Church, Canonsburg, PA - Census Information Form
General Contact Information
Prefix
*
First Name
*
Middle Name
Last Name
*
Suffix (if applicable)
Baptismal Name
*
Email Address
Mobile Phone Number
*
Home Phone
Street Address
*
Second Line Street Address (if applicable)
City
*
State
*
Zip Code
*
Date of Birth
*
Gender
*
A
Male
B
Female
Ecclesiastical status
*
A
Baptized Orthodox Christian (in good standing)
B
Baptized Orthodox Christian (estranged from the Church)
C
Catechumen
D
Inquirer
E
Married or Engaged to an Orthodox Christian, but not Orthodox
F
Other
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