Knanaya Catholic Archdiocese of Kottayam

Knanaya Catholic Archdiocese of Kottayam

Total: 4 pages

(Fields Marked * are mandatory)

Family Member Details Form

Parish: * /
(as entered in the family details form)
Ward: * /
(as entered in the family details form)
Family: * /
(as entered in the family details form)
First Name: * / / Middle Name: /
Last Name: / / Head of the family? /
(If this member is the head of this family, type ‘Yes’. Otherwise type ‘No’)
Relation: / Of (First box: type the relation type. E.g.: ‘Wife’, ‘Son’, ‘’ ‘Daughter’, ‘Brother’ etc…
Second box: type the name of the member(of this
Family) with whom this relation exists. For example, if this member is the wife of family member ‘Mathew John’ , then type ‘Wife’ in first box and ‘Mathew John’ in second box.)
NB: If this member is the head of the family, these boxes can be left blank.
Baptism Name: / / Date of Birth: /
(In ‘dd-mm-yyyy’ format.
E.g.: 16-06-1970)
Father’s Name: / / Mother’s Name: /
Family name of Parents:
(if they are not residing with the member) / / Parish of Parents:
(if they are not residing with the member) /
Mobile No.1: /
(Country Code in 1st box & number in 2nd box) / Mobile No.2: /
(Country Code in 1st box & number in 2nd box)
Email ID 1: / / Email ID 2: /
Gender: /
(Type ‘Male’ or ‘Female’) / Missionary? /
(Type ‘Yes’ or ‘No’)
Residing within the parish territory? /
(Type ‘Yes’ or ‘No’) / Country: /
Place: / / Status: /
(Type ‘Single’, ‘Married’, ‘Widow’, ‘Widower’, ‘Divorced’, ‘Priest’, ‘Nun’, ‘Brotherhood’, ‘Aspirant’, ‘Student’, ‘Child’, ‘Seminarian’, ‘Separated’ or ‘Novice’)
Qualification: /
(If you have more than one qualification, please type all those separated by comma.
E.g. : MSc, MEd) / Specialization: /
Employed? /
(Type ‘Yes’ or ‘No’) / Occupation type: /
(Type ‘Central Government’, ‘Government’, ‘Semi-government’, ‘Corporate’, ‘Private’ or ‘Parish’)
Occupation: / / Working in a firm of Diocese? /
(Type ‘Yes’ or ‘No’)
Type of Diocese Occupation: /
(If working in a firm of Diocese) / Diocese Occupation: /
(If working in a firm of Diocese)
Diocese address: /
(If working in a firm of Diocese) / Diocese Phone: /
(If working in a firm of Diocese)
Association Memberships: /
(Type the position in the associations like KCYL, KCSL, CML, KCWA etc…)
E.g. : KCYL member
If more than one, please enter all those separated by comma. / Council Memberships: /
(Type the position in Parish Council & Pastoral Council)
E.g.: Parish Council Member
If more than one, please enter all those separated by comma.
Alternate Address: /
(If your current address of residence is different from your family address)
Previous house: / / Previous Parish: /
Office Phone: / / Fax: /
Hobbies: / / Blood Group: /
Achievements: /

Knanaya Catholic Archdiocese of Kottayam Page 1