Census & Sacramental Information
Household:
Last Name:
Address:
Unit #
Name of Development:
City:

State:

Zip:

Home Phone Number:
Adults in Household:

Self:

Title:
First & Last Name:
Goes By Name (Nickname):
Birth Date

Marital Status:

Race/Ethnic:

Religion:

Occupation:

Cell Phone:

E-mail Address:
Please check which Sacraments received:
Baptized (Confession)
Reconciliation		 First
Communion		 Confirmation Catholic Marriage

Spouse:

Title:
First & Last Name:
Goes By Name (Nickname):
Birth Date

Marital Status:

Race/Ethnic:

Religion:

Occupation:

Cell Phone:

E-mail Address:
Please check which Sacraments received:
Baptized (Confession)
Reconciliation		 First
Communion		 Confirmation Catholic Marriage

Are you a part time Florida resident? Yes No

Residence when not in Florida
Address:
City:
State:
Zip:
Phone Number:

How many months are you at this address? 

Which months do you reside at this address?
From:  To:

 

Children Living At Home
Do you have children living at home? Yes No

Name:

First Middle Last

Birth Date:
Please check which Sacraments received:
Baptized (Confession)
Reconciliation		 First
Communion		 Confirmation

Name:

First Middle Last

Birth Date:
Please check which Sacraments received:
Baptized (Confession)
Reconciliation		 First
Communion		 Confirmation

Name:

First Middle Last

Birth Date:
Please check which Sacraments received:
Baptized (Confession)
Reconciliation		 First
Communion		 Confirmation

Name:

First Middle Last

Birth Date:
Please check which Sacraments received:
Baptized (Confession)
Reconciliation		 First
Communion		 Confirmation

Stewardship

We record all identifiable gifts.  Any donations totaling over $250.00 in any tax year will be acknowledged with a tax contribution statement in January.
What is your preference for tithing?
If you choose weekly envelopes they will be mailed to you shortly.

If you would like to make contributions by credit card just print out the credit card form (you will need Acrobat Reader) and return it via fax (267-5481), mail, or drop into offertory basket.

Are there any special circumstances we need to be aware of in order to serve you?

 

Our Lady of Light Catholic Community
19680 Cypress View Drive Fort Myers, Florida 33967
Telephone (239) 267-7088  Fax (239) 267-5481
info@ourladyoflight.com 

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