Parish Census

Please fill out this form and click submit.

Date

*

Family Last Name

*

Address

*

Family Residence

*

Please select one option.

Tenant Owner

Household Phone (Landline)

List only those living with you. Please include the last name if different. If not applicable, please type N/A. Thank you.

Husband/Male Head of Household

Date of Birth

Status

Please select one option.

Married Separated Divorced Widowed Single

Religion

Sacraments

Please select all that apply.

Baptism - Yes Baptism -No 1st Comm. - Yes 1st Comm. - No Confirm - Yes Confirm - No N/A

Occupation

Email

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Cell Phone

Wife/Female Head of Household

Status

Please select all that apply.

Married Separated Divorced Widowed Single

Date of Birth

Religion

Sacraments

Please select all that apply.

Baptism. - Yes Baptism - No 1st Comm. - Yes 1st Comm. - No Confirm. - Yes Confirm. - No N/A

Occupation

Email

This address will receive a confirmation email

Cell Phone

Child 1

Date of Birth

Sacraments

Please select all that apply.

Baptism - Yes Baptism - No 1st Comm. - Yes 1st Comm. - No Confirm. - Yes Confirm. - No N/A

School & Grade

Child 2

Date of Birth

Sacraments

Please select all that apply.

Baptism - YesOption Baptism - No 1st Comm. - Yes 1st Comm. - No Confirm. - Yes 1st Comm. - No N/A

School & Grade

Child 3

Date of Birth

Sacraments

Please select all that apply.

Baptism - Yes Baptism - No 1st Comm. - Yes 1st Comm. - No Confirm. - Yes Confirm. - No N/A

School & Grade

Others living with you

Description

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