Family Registration/census Form - Olca printable pdf download

FAMILY REGISTRATION/CENSUS FORM

Our Lady Comforter of the Afflicted Parish

920 Trapelo Road, Waltham, MA 02452 · 781-894-3481

Please Print Clearly

*Envelope #: ________

*Check Here If You Want To Receive Envelopes: _______ OR

Check Here If You Would Like To Do Electronic Funds Transfer (EFT) _______

LAST NAME: _________________________________________________________________________

ADDRESS, CITY, STATE, ZIP: __________________________________________________________

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HOME PHONE: ______________________ EMAIL ADDRESS: _______________________________

GENERAL HOUSEHOLD INFORMATION

Marital Status: ________

If married, Anniversary Date ______________________

FIRST NAME:

FIRST NAME: (if wife, add maiden name)

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Date of Birth: _______________________

Religion: ___________________________

Occupation: _________________________

PERSONS IN HOUSEHOLD: (Aside from people listed above, list all PERSONS living at above addr)

DATES OF BIRTH:

PLS. SPECIFY IF CHILD/PARENT/OTHER

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Thank you and welcome to Our Lady’s Parish

Faith Community

Please drop this form in the collection basket or mail it to the Parish Offices at the address listed above.

Family Registration/census Form - Olca