IC Parish Census | OLG+IC+SJ

CHURCH OF THE IMMACULATE CONCEPTION

Parish Census

We're not just counting households—we're reconnecting with our parish family. Please complete one form per household.

Household Information

First name

Last name

Phone

Email

Street address

City

State

ZIP

Family Members

Please list the other members of your household (age is optional).

Family member 1 — name

Family member 1 — age

Family member 1 — relationship

Family member 2 — name

Family member 2 — age

Family member 2 — relationship

Family member 3 — name

Family member 3 — age

Family member 3 — relationship

Family member 4 — name

Family member 4 — age

Family member 4 — relationship

Family member 5 — name

Family member 5 — age

Family member 5 — relationship

Family member 6 — name

Family member 6 — age

Family member 6 — relationship

Family member 7 — name

Family member 7 — age

Family member 7 — relationship

Family member 8 — name

Family member 8 — age

Family member 8 — relationship

Staying Connected

Homebound / Parish Visit

We'd like to know how we can serve you. Is anyone in your household homebound and interested in a parish visit or Holy Communion?

Yes

No

Other Ways We Can Connect

Check all that apply

I would like information about parish ministries or activities.

I am interested in volunteering or learning about ways to help.

I would like someone from the parish to contact me.

Prayer request — please share a prayer intention you would like our parish family to remember

Anything else you'd like us to know?