CONFIDENTIAL CENSUS DATA for SAINT LEO CHURCH

 

FAMILY NAME: ______________________________________________________________       

 

ADDRESS: ___________________________________________________________________

 

PHONE # ________________________ 

 

 

Head of House: ______________________________          Spouse ______________________________           

                                                                             (also print maiden name)

Date of Birth               _________________________                      ___________________________

Religion                      _________________________                      ___________________________

Baptism/where            _________________________                      ___________________________

First Com./where        _________________________                      ___________________________

Confirmation/where    _________________________                      ___________________________

Occupation                  _________________________                      ___________________________

 

Were you married in Church?             Yes        Where? _________________________  When? __________                                                                No       

 

 

Please print the names of all others 18 and older actually living in this house (include last name if different):

 

Name                                                               Date of Birth               Sacraments Received

 

_________________________________      ____________            _______________________________

 

_________________________________      ____________            _______________________________

 

_________________________________      ____________            _______________________________

 

 

 

 

Please print the names of all children under 18 actually living in this house (include last name if different):

 

Name                                                   Date of Birth               School & Grade                      Sacraments Received

 

_____________________________  _______________      ________________                __________________

 

_____________________________  _______________      ________________                __________________

 

_____________________________  _______________      ________________                __________________

 

_____________________________  _______________      ________________                __________________

 

_____________________________  _______________      ________________                __________________