Census Form

Dear Friend,

We welcome you to Immaculate Conception Catholic Parish.

We hope that you find here a family of friends who can be your companions in our common journey to follow the Lord.

A parish is only as alive as the members make it.

We feel that you will find much that is beautiful and loving in our parish life. We look forward to being enriched by your presence and your gifts.

If you have any questions about this form or about the parish, please call the rectory at 452-3533 .

When completed simply click PRINT and either 1) drop the survey in the collection basket; 2) provide your survey to the Parish Office; or 3) mail your survey to ICC Parish, 115 N Cushman St, Fairbanks, AK 99701-2830

Thank you for joining our parish.                                                                                      Fr Mirek Woznica

 

All information provided will be kept confidential

Family Name:

Street Address:          PO Box

Apt.# or Floor:

City:         Zip:

E-mail:

Telephone: Day: Evening: Cell:

When did you move to this area?

ADULT       DATE OF BIRTH

First Middle (Maiden)

Status:  Single    Married    Divorced    Widow(er)    Cath.     Non-Cath

Occupation

Married in Catholic Church               Ecumenical Service                    Other

Baptized        Communion        Confirmed

ADULT       DATE OF BIRTH

First Middle (Maiden)

Status:  Single    Married    Divorced    Widow(er)     Cath.     Non-Cath

Occupation

Married in Catholic Church               Ecumenical Service                    Other

Baptized        Communion        Confirmed

CHILDREN AT HOME

                      Name                          Date of Birth        Bapt     Comm      Conf           Grade

                                First Middle (Family if different)

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OTHER ADULTS

NAME       Date of Birth

Relationship to family        Occupation

Baptized          Communion            Confirmed

SPECIAL NEEDS

Are there any special needs in your family (e.g. sick, confined to home)?    Yes     No

Please specify

FOR NON CATHOLICS

Would you like to know more about the Catholic Church?                      Yes       No

PARISH SUPPORT  Do you wish to receive parish envelopes?        Yes          No

TODAY’S DATE