Parish Census Form

For those who wish to register with Our Lady of Lourdes Parish or for current Parishioners with changes to their address, marital status, etc.

FAMILY NAME *
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Preferred form for mailings (Mr. & Mrs., etc.) *
Phone Phone * - ### - ### ####
Email *
Current Marital Status *

Current Marital Status Married Single Widowed Divorced Date of Marriage Date of Marriage
We were married within the Catholic Church.

We were married within the Catholic Church. Yes Other, please explain Other, please explain
NAMES
HEAD OF HOUSEHOLD *

Include Maiden Name, if applicable
Maiden Name if applicable
Religion *
Date of Birth Date of Birth * / MM / DD YYYY
Sacraments Received

Sacraments Received Baptism Communion Confirmation
Occupation
Employer
Work Phone Work Phone - ### - ### ####
SPOUSE

Include Maiden Name, if applicable
Religion
Date of Birth Date of Birth / MM / DD YYYY
Sacraments Received

Sacraments Received Baptism Communion Confirmation
Occupation
Employer
Work Phone Work Phone - ### - ### ####
NAMES of all other persons living in the household (please include relationship, i.e. Son, Daughter, Mother, etc.)

This is the description of your section break.
Name and relationship to head of household
Maiden Name
Religion
Date of Birth Date of Birth / MM / DD YYYY
Sacraments Received

Sacraments Received Baptism Communion Confirmation
School Attending or Occupation and Employer
Name and relationship to head of household
Religion
Date of Birth Date of Birth / MM / DD YYYY
Sacraments Received

Sacraments Received Baptism Communion Confirmation
School Attending or Occupation and Employer
Name and relationship to head of household
Religion
Date of Birth Date of Birth / MM / DD YYYY
Sacraments Received

Sacraments Received Baptism Communion Confirmation
School Attending or Occupation and Employer
Name and relationship to head of household
Religion
Date of Birth Date of Birth / MM / DD YYYY
Sacraments Received

Sacraments Received Baptism Communion Confirmation
School Attending or Occupation and Employer
Name and relationship to head of household
Religion
Date of Birth Date of Birth / MM / DD YYYY
Sacraments Received

Sacraments Received Baptism Communion Confirmation
School Attending or Occupation and Employer
Name and relationship to head of household
Religion
Date of Birth Date of Birth / MM / DD YYYY
Sacraments Received

Sacraments Received Baptism Communion Confirmation
School Attending or Occupation and Employer
Name and relationship to head of household
Religion
Date of Birth Date of Birth / MM / DD YYYY
Sacraments Received

Sacraments Received Baptism Communion Confirmation
School Attending or Occupation and Employer
Comments

Parish Census Form

Parish Census Form

NAMES

NAMES of all other persons living in the household (please include relationship, i.e. Son, Daughter, Mother, etc.)