Please enable JavaScript in your browser to complete this form.Electoral Roll Please see the attached leaflet which explains what the electoral roll is all about. The information you provide will only be used for the purpose of compiling our electoral roll this year onwards until 2030. We will never share or sell this information, Please see our privacy policy Title if desiredFirst Name *Family Name *EmailYour email address is not required but is helpful if we have any queries. It won't be published or added to any mailing list. Address Address 1 *Address 2CityPost Code *Please tick one of the options below Declaration. Please choose one of the options below *A) I am baptised, am a lay person, and am aged 16 or overB) I am baptised, am a lay person and will be 16 within the next twelve months.If you have ticked B please give your date of birth belowDeclaration Please tick one of the options below. *A) 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.BI am a member of the Church of England or of a Church in communion with the Church of England, am not resident in the parish, but have habitually attended public worship in the parish during the preceding six monthsC) I am a member of the Church of England or of a Church in communion with the Church of England, am not resident in the parish, and would have habitually attended public worship in the parish during the preceding six months but was prevented from doing so because..D) I am a member in good standing of a Church which is not in communion with the Church of England but subscribes to the doctrine of the Holy Trinity, am also a member of the Church of England and have habitually attended public worship in the parish during the preceding six monthsE) I am a member in good standing of a Church which is not in communion with the Church of England but subscribes to the doctrine of the Holy Trinity, am also a member of the Church of England and would have habitually attended public worship in the parish during the preceding six months but was prevented from doing so because ......If you have ticked either of Boxes C or E please complete the reason you were unable to habitually attend. Please note our privacy policy in regard to this information which will be held only for the purpose of this roll and will not be shared.if you are not sure if you are in the Parish you can check this with a A churchnearyou I declare that the above answers are true and I apply for inclusion on the church electoral roll Signature - an electronic signature is sufficient *Date *Website / URLSubmit
