Parish Census Form 2020 OLA, Latham, NY
Our Lady of the Assumption Parish, 498 Watervliet-Shaker Road, Latham NY 12110 Telephone: (518)785-0234
Please provide us with the following information so that we may better serve your needs.
Thank you for your assistance. All information will remain confidential and will not be shared.
First Name *
Middle Name *
Last Name *
Date of Birth *
Please be sure to enter the correct year, as 2020 will default.
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Street Address *
Town/City *
State *
Zip Code *
Email *
Home Phone number
Cell Phone number
Name of Additional Household member 1
Date of Birth Additional Household member 1
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DD
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YYYY
Name of Additional Household member 2
Date of Birth Additional Household member 2
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DD
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YYYY
Name of Additional Household member 3
Date of Birth Additional Household member 3
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MM
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DD
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YYYY
Name of Additional Household member 4
Date of Birth Additional Household member 4
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MM
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DD
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YYYY
Name of Additional Household member 5
Date of Birth Additional Household member 5
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MM
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DD
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YYYY
Name of Additional Household member 6
Date of Birth Additional Household member 6
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MM
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DD
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YYYY
Name of Additional Household member 7
Date of Birth Additional Household member 7
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DD
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YYYY
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