Parish Census Card

Postcard sized Parish Census Cards are available on the parish bulletin board and may be completed and returned to the Rectory Office to update household information or to register as a new parish household.

OR

Contact the Rectory Office at icsja@icsja.net or 573-431-2427 to register with the parish!

OR

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?