Parish Census Update Form

Our goal is to maintain the most accurate records as possible. Even if you think we have your current information, please fill out this form so we can verify it. It is our goal to reach 100% of the registered parish households during this "Data Drive." Thank you.

Name Name First Last
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Primary Phone number Primary Phone number - ### - ### ####
Is your primary phone a cell phone or landline?
Secondary phone number Secondary phone number - ### - ### ####
Is your secondary phone a cell or landline?
Do you have an Email address?
Email
Do you wish to receive Parish emails?
Marital Status
Spouse Name: Spouse Name: First Last
Spouse Address (if different than above) Spouse Address (if different than above)
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Spouse's Primary Phone Spouse's Primary Phone - ### - ### ####
Is your spouse's primary phone a cell phone or landline?
Spouse's Secondary Phone Spouse's Secondary Phone - ### - ### ####
Is your spouse's secondary phone a cell or landline?
Does your spouse have an Email address?
Email of Spouse
Does your spouse wish to receive Parish emails?
Comments:
Spam Protection. Please answer this simple question:
What is "three hundred" as a number?