APPLICATION FOR ENROLMENT ON THE CHURCH ELECTORAL ROLL

 OF THE PARISH OF

ST BARTHOLOMEWS AND ST CHRISTOPHERS, HASLEMERE

Registered Charity No. 1127927

Synodical Government Measure 1969

Your privacy is important to us and we want to communicate with you in line with UK law on data protection. As a result of a change in UK law, we now need your consent in order to stay in touch. We will only use your postal and email address for communicating with you on matters relating to the Electoral Roll and will not pass your details on to any third parties.  Your information will be kept securely and you can change your mind at any time by contacting the Parish Administrator at office@haslemereparish.co.uk.  A copy of our privacy policy is available from the Parish Administrator or from our website www.haslemereparish.org/info/data-privacy/.


Title:
Surname:
Forenames:
Address 1:
Address 2:
Address 3:
Address 4:
Address 5:
Postcode:
Phone Number:
Email:
I Declare That:
I am baptised
I am over 16 years old
Please tick just one of the statements :*
Statement A: I am a member of the Church of England (or of a Church in communion with the Church of England) and I am resident in the parish.
Statement B: I am a member of the Church of England (or of a Church in communion with the Church of England) and, not being a resident in the parish, I have habitually attended public worship in the parish during the period of six months prior to enrolment OR would have but was prevented from doing so because... (please provide detail below)
Statement 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 but was prevented from doing so because... (please provide detail below)
If you selected Statement B or C above, please provide detail :
Please enter the verification number:*
one four six three two
* Required Fields