Parish Census Card

Please print and complete the Parish Census Card provided below.  Completed cards may be returned to the Rectory Office at PO Box 66, Park Hills, MO  63601 or simply drop into the Sunday Collection basket at your earliest convenience.  Thank you.
 
(Hint:  To print only the Parish Census Card and not the menu at left, left click and hold down to select only what you wish to print.  Next, right click and choose Print then under "Page Range" choose  "Selection" and " Print".)
 
Please Note:  If you are transferring from a different parish, your previous parish needs to remove your household from their membership.  Please provide them with a courtesy call if you have not already done so.
 
 

PARISH CENSUS CARD
 
Family Name:_________________________________________________________________________
 
Address:_____________________________________________________________________________
 
City/State/Zip:_________________________________________________________________________
 
Phone:____________________________________
 
Husband:____________________ Birth Date:____________________  Religion:  C or N/C
 
               Baptized:  Y or N          1st Communion:  Y or N          Confirmation:  Y or N          Shut-In:  Y or N
 
Occupation:____________________________________
 
Wife:_______________________  Birth Date:____________________  Religion:  C or N/C
 
               Baptized:  Y or N          1st Communion:  Y or N          Confirmation:  Y or N          Shut-In:  Y or N
 
Occupation:____________________________________
 
Marital Status:  Married    Single     Separated     Divorced     Widowed     Married by Priest?_____
 
Would you like to receive monthly envelope packets?  Y or N
 
Would you like to receive the St. Louis Review?  Y or N
 
Previous Parish Name & Address:_________________________________________________________
 
                                                       _________________________________________________________
 
Children and/or Other Adults Living in Your Household
Please give ages and birth dates:
 
______________________________  Birth Date: ____________________  Relgion:  C or N/C
 
               Baptized:  Y or N          1st Communion:  Y or N          Confirmation:  Y or N          Shut-In:  Y or N
 
______________________________  Birth Date: ____________________ Relgion: C or N/C
               Baptized: Y or N           1st Communion: Y or N           Confirmation: Y or N           Shut-In: Y or N
 
______________________________ Birth Date: ____________________ Relgion: C or N/C
 
              Baptized:  Yor N           1st Communion: Y or N            Confirmation: Y or N           Shut-In: Y or N
 
______________________________ Birth Date: ____________________ Relgion: C or N/C
              Baptized: Y or N          1st Communion:  Y or N           Confirmation: Y or N           Shut-In: Y or N
 
______________________________ Birth Date: ____________________ Relgion: C or N/C
             Baptized: Y or N           1st Communion: Y or N            Confirmation:  Y or N         Shut-In: Y or N
 
Number of family members in your household that attend this parish?
 

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