Our Lady of Mount Carmel Church | Catholic Church, Talegaon Dabhade

1

Family Demographics & Residence Details (Table 1)

Official Parish Census Record (Page 1) • Sequence aligned with the Physical Form. Please fill out all fields in CAPITAL LETTERS.

FAMILY ID:[Auto-Assigned on Submit]

Head of the Family *Automatically bound to Member #1 (HE: Head of the family)

Zone *

Community *

Reg. date/Year *

Flat / Room No. *

Building /Chawl Name *

Road/ Street *

Area/Locality *

Land Mark *

Last Parish Name, Area or state before joining this Parish *

Family Type *

NuclearJoint

House Type *

House Status *

Mother Tongue *

Origin State *

Main Contact No *

Domicile in this Parish/Area since *

2

Family Members Details (Official 3 Tables)

Member #1 is the Head of the Family. Add up to 12 members.

Table 1: Personal & Demographic Info (Member #1)Head of Family

Full Name (Head of Family) *

Gender *

Marital Status *

Birth Date (DD/MM/YYYY) *

Blood Group *

Relation to Head of Family *

Birth Place *

Home Bound

Languages Known (Select from 28 Languages) *Selected: 0

Anniversary Date Disabled (Applicable for Married / Separated status only)

Mobile No. *

WhatsApp No. (Optional)

Table 2: Contact, ID, Education & Occupation (Member #1)

E-Mail ID

PAN Card No.

Aadhaar Card No.

Educational Qualification *

School / College Name (Not Applicable)

Occupation *

Occupational Category (P1 to P24) *

Table 3: Sacraments, Ministries & Resident Status (Member #1)

Passions For (Select up to 5) *Selected: 0 / 5

Church Cell & Association (Multiple Options Selectable) *Selected: 0

Cell & Association Position *

Church Ministry *

Resident Status *

Social Service (Multiple Options Selectable) *Selected: 0

Note / Remark

3

Verification & Declaration

I hereby declare that all information furnished in this Parish Census Card is true and correct to the best of my knowledge and belief. I acknowledge that this information will be retained in the Church Records for pastoral care and official parish administration.

I confirm and accept the declaration as Head of the Family *

Signature (Head of Family):

Parish Family Census Registration Form

Family Demographics & Residence Details (Table 1)

Family Members Details (Official 3 Tables)

Verification & Declaration