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Household Name REQUIRED Please fill out this field. Please enter valid data.

Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Home/Main Telephon Number REQUIRED Please fill out this field. Please enter a phone number.

Is the phone number unlisted? Yes

Do you need Offertory Envelopes? (If you give in cash, you do. If you give with a check or by credit card, you do not.) REQUIRED Yes. I give in cash and need envelopes. No. I will contribute by check and/or credit card. Please fill out this field.

Head of Household #1

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Nickname Please enter valid data.
Date of birth REQUIRED Please fill out this field. Please enter a date.
Marital Status REQUIRED Please fill out this field.
Sex REQUIRED Please fill out this field.
Email REQUIRED Please fill out this field. Please enter an email address.
Mobile Phone Maximum 20 characters Please enter a phone number.
Religion REQUIRED Please fill out this field. Please enter valid data.
Occupation Please enter valid data.
Employer Please enter valid data.
Race/Ethnicity REQUIRED Please fill out this field.
Baptism Date and Location (if known) Please enter valid data.
1st Communion Date and Location (if known) Please enter valid data.
Confirmation Date and Location (if known) Please enter valid data.
Marriage Date and Location Please enter valid data.

Are Head of Household #1 & #2 Married to each other? Yes No Does not apply

If their is no second head of household, skip to "Household Members" below to add other people.
If the household is only one person, skip to the bottom and submit without adding others.

Head of Household #2

First Name Please enter valid data.

Last Name Please enter valid data.
Nickname Please enter valid data.
Date of birth Please enter a date.
Marital Status
Sex
Email Please enter an email address.
Mobile Phone Maximum 20 characters Please enter a phone number.
Religion Please enter valid data.
Occupation Please enter valid data.
Employer Please enter valid data.
Race/Ethnicity
Baptism Date and Location (if known) Please enter valid data.
1st Communion Date and Location (if known) Please enter valid data.
Confirmation Date and Location (if known) Please enter valid data.
Marriage Date and Location Please enter valid data.

Other Household Member

Household Position
First Name Please enter valid data.

Last Name Please enter valid data.
Nickname Please enter valid data.
Date of birth Please enter a date.
Marital Status
Sex
Email Please enter an email address.
Mobile Phone Maximum 20 characters Please enter a phone number.
Religion Please enter valid data.
Occupation Please enter valid data.
Employer Please enter valid data.
Race/Ethnicity
Baptism Date and Location (if known) Please enter valid data.
1st Communion Date and Location (if known) Please enter valid data.
Confirmation Date and Location (if known) Please enter valid data.
Marriage Date and Location Please enter valid data.

Other Household Member

Household Position
First Name Please enter valid data.

Last Name Please enter valid data.
Nickname Please enter valid data.
Date of birth Please enter a date.
Marital Status
Sex
Email Please enter an email address.
Mobile Phone Maximum 20 characters Please enter a phone number.
Religion Please enter valid data.
Occupation Please enter valid data.
Employer Please enter valid data.
Race/Ethnicity
Baptism Date and Location (if known) Please enter valid data.
1st Communion Date and Location (if known) Please enter valid data.
Confirmation Date and Location (if known) Please enter valid data.
Marriage Date and Location Please enter valid data.

Other Household Member

Household Position
First Name Please enter valid data.

Last Name Please enter valid data.
Nickname Please enter valid data.
Date of birth Please enter a date.
Marital Status
Sex
Email Please enter an email address.
Mobile Phone Maximum 20 characters Please enter a phone number.
Religion Please enter valid data.
Occupation Please enter valid data.
Employer Please enter valid data.
Race/Ethnicity
Baptism Date and Location (if known) Please enter valid data.
1st Communion Date and Location (if known) Please enter valid data.
Confirmation Date and Location (if known) Please enter valid data.
Marriage Date and Location Please enter valid data.

Other Household Member

Household Position
First Name Please enter valid data.

Last Name Please enter valid data.
Nickname Please enter valid data.
Date of birth Please enter a date.
Marital Status
Sex
Email Please enter an email address.
Mobile Phone Maximum 20 characters Please enter a phone number.
Religion Please enter valid data.
Occupation Please enter valid data.
Employer Please enter valid data.
Race/Ethnicity
Baptism Date and Location (if known) Please enter valid data.
1st Communion Date and Location (if known) Please enter valid data.
Confirmation Date and Location (if known) Please enter valid data.
Marriage Date and Location Please enter valid data.

Test Site of the Doug

All other are in violation of Article 37 Section 359

omg delete

Parish Census Form