ON-LINE APPLICATION FOR ENROLMENT ON THE CHURCH ELECTORAL ROLL

Full name *

Full Address

Postcode

Telephone number

Mobile number

email address

I am baptized and am aged 16 or over *

Yes

No

I am baptized and will shortly become 16

Yes

No

Date of 16th birthday

Please tick one of the following *

I am a member of the Church of England (or of a Church in communion with the Church of England) and am a resident in the parish.

I am a member of the Church of England (or a Church in communion with the Church of England) and

not being resident in the parish

I have habitually attended public worship in the parish during the period of six months prior to enrolment.

I am a member in good standing of a Church (not in communion with the Church of England) which subscribes to the doctrine of the Holy Trinity and also declare myself to be a member of the Church of England and I have habitually attended public worship in the parish during the period of six months prior to enrolment.

I declare that the above answers are true and I apply for inclusion on the Church Electoral Roll of the above named parish. *

Yes

No