Full CTMM Application Form

Name

First Name(s)Surname

Birth Date*

DayMonthYear

Age*

Sex*

Ethnicity*

Address*

Street Address

Street Address Line 2

CityCounty

Postal / Zip Code

E-mail*

example@example.com

Contact Number*

Phone Number

Area CodePhone Number

Emergency Contact Name*

Emergency Contact Number*

Your Occupation

If you're retired please state your previous occupation

Church & Parish

Please state church name and parish, eg: St John's, Long Eaton

Deanery*

Vicar / Supervisor's Name*

Vicar / Supervisor's Email*

Vicar / Supervisor's Phone Number*

Specialist Pathway

Please select which specialist pathway that interests you. *If you choose Licensed Lay Ministry (Reader) we will send you another form for additional information so that we can start you at the best point for you.

Are you in, or interested in, the process of discernment for ordination?

YesNo

Would you like to take the Assignments?**

YesNo

*If yes, we will need to ask your vicar (or someone else in authority in a vacancy) for their support for you to take the course as they will need to be present for the delivery of, and comment on, your specialist module assignment. Please note however that Certificate does not imply or confer any authority to minister anywhere in the Diocese including your own church, that is entirely in the gift of your Vicar as is the responsiblity for ensuring that you have the correct level of DBS check and safeguarding training in place should they invite you to minister.

Will you commit to posting on the Forum, and commenting on someone else's post, once every week during term time, so that you can learn from your fellow students and they can learn from you? (please note you can't register onto the course with assignments unless you are prepared to do this).

YesNo

Is there anything you'd like us to know that will help us to support you in your learning?

For example, if you have any kind of neurodiversity or other disability or health condition that might affect your studies it's helpful to know so we can make reasonable adjustments to support you.

I understand that I am applying for the whole, 2 year, Certificate in Theology of Mission & Ministry programme and will be registered onto the next module running*

YesNo

How did you hear about the course*

Are you happy to have your first name and parish appear on a Diocesan map that only other course participants can see?

YesNo

Are you happy for us to share your email address with other course participants?

YesNo

Safeguarding Declaration*

Please state if you, or anyone in your household, has ever been refused a DBS certificate or has been implicated in any Safeguarding situation. if not please state 'Nothing to declare'. Please note that as we process your application we will send your details to the Diocesan Safeguarding team to check that there are no issues we need to be aware of.

Signature*

By signing this form you are stating that you have read and understood all the information and that everything you have stated is true and accurate to the best of your knowledge.

Date*

Date

PRIVACY NOTICE

Personal Data Collection Statement
Last Updated: February 2026

Purpose of Data Collection
The data collected on this form is used to facilitate your participation in our course and to provide appropriate support throughout your learning journey. This includes administrative purposes, educational support, and understanding the diversity and needs of our student community to ensure inclusive and effective training provision.

Legal Basis for Processing
Your personal data will be processed on the following legal bases under the UK General Data Protection Regulation (UK GDPR):

Contractual Necessity - For the performance of our contract with you to provide educational services (Article 6(1)(b) UK GDPR)
Legitimate Interests - To understand student diversity and needs, improve our courses, and ensure equal opportunities (Article 6(1)(f) UK GDPR)
Legal Obligation - Where required for ecclesiastical licensing and compliance with Church of England regulations (Article 6(1)(c) UK GDPR)

Types of Data Collected
We collect the following categories of personal data:

Contact Information: Name, address, telephone number, email address
Personal Details: Date of birth, age, sex,
Equality and Diversity Information: Ethnicity, disability status, accessibility requirements

Data Sharing and Disclosure
Your personal data will be treated with strict confidentiality and will not be shared with third parties without your prior written consent, except where required by law or for the legitimate purposes of your training. This may include:

Internal sharing with authorised course tutors and administrators
Church of England Ministry Division for validation and quality assurance purposes
Relevant Diocesan officers for licensing and ministry development purposes
We will never sell your personal data or use it for marketing purposes without your explicit consent.

Data Retention Period
Your personal data will be retained for the following periods:

Licensed Ministers: For the duration of your Bishop's License or Permission to Officiate, plus an additional 7 years following the cessation of your license
Non-Licensed Students: For a period of 5 years following the completion of your module or course
After these periods, your data will be securely destroyed or anonymised in accordance with our retention policy.

Your Data Protection Rights
Under the UK GDPR, you have the following rights regarding your personal data:

Right to Access - Request a copy of the personal data we hold about you
Right to Rectification - Request correction of inaccurate or incomplete data
Right to Erasure - Request deletion of your personal data (subject to legal obligations)
Right to Restrict Processing - Request limitation of how we use your data
Right to Data Portability - Request transfer of your data to another organisation
Right to Object - Object to processing based on legitimate interests
Rights Related to Automated Decision Making - Protection from automated decision-making and profiling
To exercise these rights, please contact our Data Protection Officer using the details below.

Data Security
We implement appropriate technical and organisational measures to protect your personal data against unauthorised or unlawful processing, accidental loss, destruction, or damage. These include secure storage systems, access controls, and regular security reviews.

Changes to This Notice
We may update this privacy notice from time to time to reflect changes in our practices or legal requirements. Any significant changes will be brought to your attention.

Contact Information
For any questions, concerns, or requests regarding your personal data, please contact:

Claire Less, Director of People and Ministry Development, Church House, Full Street, Derby, DE1 3DY, Email: claire.lees@derby.anglican.org, Telephone: 01332 278175.

Complaints
If you believe we have not handled your personal data in accordance with your rights under the UK GDPR, you have the right to lodge a complaint with the Information Commissioner's Office (ICO), the UK's supervisory authority for data protection:

Information Commissioner's Office Wycliffe House Water Lane Wilmslow Cheshire SK9 5AF Telephone: 0303 123 1113 Website: www.ico.org.uk

By signing this form, you confirm that you have read and understood this privacy notice and consent to the processing of your personal data as described above.

Full CTMM Programme Application Form

Application Administration Fee