| Marital Status: |
Married
Single
Widow
Divorced |
| Do You Have Any Dependents? |
Yes
No |
Level of Education:
(check highest level completed) |
Grade School
High School
Technical Degree
Bachelors Degree
Masters Degree
Doctorate
Other: |
| Are You A Convert To Catholicism? |
Yes
No |
| Do you frequent the sacraments? |
Yes
No |