APPLICATION FOR ENROLMENT ON THE CHURCH ELECTORAL ROLL 

 

Name:

Address:
City:
Postcode:

Telephone:

Email Address:

I declare that I am: Baptised 

And I am either:
Aged 16 or over 
Or: I become 16 on 

I declare that (please tick only one box from options A, B or C):
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. 

B. 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. 

C. 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.  

* or would have attended but was prevented from doing so because: 

I declare that the above answers are true and I apply for inclusion on the church electoral roll of the parish. (Please type yes in the box):