Utah Census Form


  1. _____________________ (Given name)

  2. _____________________ (Surname)

  3. Descendant of:
    1. Brigham Young _____
    2. Heber C. Kimball _____
    3. Laman and Lemuel _____
    4. Cain _____

  4. Tribe of Israel: _____________________

  5. Number of occupants residing in home in each category: (Listed in chronological order)
    1. Nursery _____
    2. Junior Primary _____
    3. Senior Primary _____
    4. Young Women _____
    5. Young Men _____
    6. Relief Society _____
    7. Elder _____
    8. Dearly Departed _____
    9. High Priest _____

  6. Occupation [Please select all that apply.]:
    1. Amway dealer _____
    2. Shaklee dealer _____
    3. Noni juice dealer _____
    4. NuSkin dealer _____
    5. Melaleuca dealer _____

  7. Automobile:
    1. Station Wagon _____
    2. Van _____
    3. Suburban _____
    4. School Bus _____
    5. Double Decker _____

  8. Favorite place to eat the night before Fast Sunday:
    1. Chuck-A-Rama _____
    2. Hometown Buffet _____
    3. Sumo Sam's All You Can Eat Feeding Trough _____

  9. Favorite Hero:
    1. Nephi _____
    2. Abinadi _____
    3. Samuel the Lamanite _____
    4. Steve Young _____
    5. Johnny Lingo _____

  10. Which of the following do you bring to church [check all that apply.]:
    1. Scriptures _____
    2. Franklin Planner/Daytimer _____
    3. Blackberry/PDA _____
    4. Pen/Pencil _____
    5. Lifesavers/Cheerios _____
    6. Tic Tacs _____
    7. Game Boy _____
    8. Big Gulp _____
    9. Sony Walkman _____
    10. TV Watch _____
    11. All of the above _____

  11. Do you prepare your church lessons:
    1. A month in advance _____
    2. A week in advance _____
    3. While in the bathtub _____
    4. During Sacrament Meeting _____
    5. During the closing prayer of Sacrament Meeting _____
    6. During the opening prayer of the class you're teaching _____
    7. Just wing it [according to the promptings of the Spirit] _____

  12. How many years has your family sat in the same place for Sacrament Meeting:
    1. 10-20 years _____
    2. 20-30 years _____
    3. 30-40 years _____
    4. Over 3 generations _____
  1. How much time does it take for you to fall asleep during a high council talk:
    1. 1/100,000,000th of a second _____
    2. 1/999,999,999th of a second _____
    3. 1/999,999,998th of a second _____

  2. Which day of the month do you go home/visiting teaching:
    1. 31st _____
    2. 31st _____
    3. 31st _____
    4. 31st _____

  3. How many church basketball fights were you in last year:
    1. 1-10 _____
    2. 10-20 _____
    3. 20-30 _____
    4. You'll have to ask my lawyer _____

  4. Which of the following has been your most effective Family Home Evening:
    1. Arguing about getting along _____
    2. Having an opening and closing prayer with dinner _____
    3. Gathering around the television to watch, "Johnny Lingo" _____

  5. How many times a year do you make:
    1. Green Jell-O salad _____
    2. Funeral potatoes _____
    3. Cabbage and Top Ramen salad _____

  6. How many water-filled two-liter bottles do you own:
    1. 1-2 thousand _____
    2. 2-3 thousand _____
    3. 3-4 thousand _____
    4. Enough to fill the Great Salt Lake _____

  7. Which of the following do you feel is the most secure facility in the nation:
    1. Alcatraz _____
    2. Fort Knox _____
    3. Ward Libraries _____

  8. How many structural engineers do you hire annually to insure you'll win the pinewood derby: _________

  9. Keeping the Word of Wisdom in mind, how much of the following do you consume:
    1. Chocolate: _____ pounds daily X 365 days annually= _____
    2. Pop: _____ gallons daily X 365 days annually = _____

  10. If you had to choose between witnessing the Second Coming or attending a BYU - UofU football game, which would you choose?
    1. Second Coming _____
    2. Football game _____