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APPLICATION FOR ENROLMENT
ON THE CHURCH ELECTORAL ROLL
Please complete this form using a ball point pen (post or scan & email to: treasurer@stsp.org.uk) or compete online using thew link on our website
Persons name
First name
Last name
Your address
Address Type
Main
House name or number
Address line 1
Address line 2
Address line 3
Address line 4
City
County
Postcode
Date of Birth
Email address
Home phone
Mobile phone
1 - I declare that (please select Yes or No in box A, and complete box B is under 16 only)
1A - I am baptised, am a lay person, and am aged 16 or over
No
Yes
1B - I am baptised, am a lay person, and become 16* on :
2 - I declare that (please select Yes or No in box A, if No to A, complete box B or C using the drop down menus - if absent for a reason please add reason under either B or C)
2A - 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.
No
Yes
2B - I am a member of the Church of England (or of a Church in communion with the Church of England) but not resident in the parish,
but have habitually attended public worship in the parish during the preceding six months
and would have habitually attended public worship in the parish during the preceding six months, but was prevented from doing so because:
Reason
2C - 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 months
and would have habitually attended public worship in the parish during the preceding six months but was prevented from doing so because:
Reason
If you select 2B or 2C in circumstances where a new Roll is being prepared, you must select the first or second statement available. If you select the second statement, you must add a reason. See Note 3 for further information.
I declare that the above answers are true and I apply for inclusion on the church electoral roll of the parish.
Signature
*
Clear
Date
Data Privacy
Just to let you know that we will hold the information that you give us securely. We will not share your information with other companies, outside of St Saviour's Pimlico without your permission, see note 7,8 & 9 below fort exceptions. We would like to keep in touch with you to let you know what is happening at St Saviours, please select your preferred communication below. You can tell us anytime if you no longer want us to keep in touch with you : office@stsp.org.uk or by phone on 020 7834 9520. Our full privacy notice can be found on our website.
OK to contact in any way
OK to telephone
OK to email
OK to post
Notes
General matters
1 The only Churches at present in communion with the Church of England are other Anglican Churches and certain foreign Churches, as listed in the Supplementary Material to the Canons (but note Rule 83(3) of the Church Representation Rules, which provides for any question as to whether a particular Church is in communion with the Church of England to be decided by the Archbishops of Canterbury and York acting jointly).
2 Membership of the electoral roll is also open to members in good standing of a Church not in communion with the Church of England which subscribes to the doctrine of the Holy Trinity where those members are also prepared to declare themselves to be members of the Church of England.
3 Every six years a new roll is prepared and those on the previous roll are informed so that they can reapply. If you are not resident in the parish but were on the roll as a habitual worshipper and have been prevented by illness or other sufficient cause from worshipping for the past six months, you should complete declaration 2B or 2C as follows –
(a) delete the first set of words in square brackets and
(b) at the end of the second set of words in square brackets, briefly state the reason for not having worshipped as mentioned.
4 If you have any problems with this Form, please approach the clergy or lay people responsible for the parish, who will be pleased to help you.
5 In this Form ‘parish’ means ecclesiastical parish.
Use of email addresses and other personal data
6 You do not have to provide an email address on this Form. If you do provide one, the Parochial Church Council and the electoral roll officer are entitled to use that email address to communicate with you in connection with the maintenance or revision of the Roll or the preparation of a new Roll or with elections to or membership of the Council.
7 The Church Representation Rules impose certain requirements for your name and address to be given to a third party, such as the diocesan electoral registration officer, in connection with elections to or membership of a deanery synod, diocesan synod or the House of Laity of the General Synod. If you provide an email address on this Form, it will be given to the third party along with your postal address.
8 A third party to whom your name and address have been given under the Church Representation Rules is in certain cases required by the Rules to pass them on to another person, such as the presiding officer in a synodical election. If you provide an email address on this Form, that email address will be given to the other person along with your postal address.
9 Any person to whom your email address or other personal data is given under the Church Representation Rules is required by those Rules to hold the data securely. Furthermore, if you do provide an email address on this Form, that does not give anybody the right to use it for any purpose other than those permitted by the Rules; so it cannot, for example, be used for social matters or fund-raising.
10 The roll is published after each annual revision and after the preparation of a new roll. The published roll will include your name (as well as the name of every other person on the roll) but none of your other personal data (as defined by the Data Protection Act 2018) will be made public as a result of your inclusion on the roll.
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