Census Form (Online)

 

 
Questions marked by * are required.
  Name *
  Email Address *
  Family Home Address
  Husband's Name
  Wife's Maiden Name
  Family Name
  Zip Code
  Phone Number
  Wife's Birthday
  Was She Baptized
  • Yes
  • No
  Religion
  Occupation
  How Were you Married
  • Catholic Priest
  • Civil Marriage
  • Minister
  • Not Married at all
  Names of Children at Home
  Birth dates of Kids
  Were they baptized
  Name the School(s) they are attending
  What Grades are they in
  Do You desire evelopes for your contributions
  • Yes
  • No
  Do You wish to recieve the Clarion Herald
  • Yes
  • No
  Husbands Birthday
 
 
 

 

 
 

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