Diocese of Ontario CPIC application form
Parish Name:
Please Select
All Saints', Tyendinaga
Christ Church, Athens
Christ Church, Belleville
Christ Church, Burritt's Rapids
Christ Church, Cataraqui
Christ Church, Gananoque
Christ Church, Glen Miller
Christ Church, Wolfe Island
Church of the Redeemer, Rockport
Church of the Trinity, Wolfe Island
Holy Trinity, Frankford
Holy Trinity, Lombardy
Holy Trinity, Maynooth
Holy Trinity, Merrickville
Holy Trinity, Oak Leaf
Leeds Anglican Ministries
St Alban's, Odessa
St Alban's, Stella
St Andrew's, Garreton
St Andrew's, Sharbot Lake
St Andrew's, Wellington
St Anne's, Oxford Station
St George's Cathedral, Kingston
St George's, Trenton
St James', Kemptville
St James', Kingston
St James', Maitland
St John the Baptist, Lyn
St John the Baptist, Madoc
St John the Evangelist, Bancroft
St John the Evangelist, Prescott
St John the Evangelist, Stirling
St John's, Bath
St John's, Portsmouth
St John's, Sunbury
St Lawrence, Brockville
St Luke's, Camden East
St Luke's, Kingston
St Mark's, Barriefield
St Mark's, Bonarlaw
St Mary Magdalene, Napanee
St Mary Magdalene, Picton
St Mary's, Newboro
St Matthew's, Marlbank
St Paul's, Brockville
St Paul's, Cardinal
St Paul's, Kingston
St Paul's, Marmora
St Paul's, Newbliss
St Paul's, Roslin
St Paul's, Sandhurst
St Paul's, Sydenham
St Paul's, Westport
St Peter's, Collins' Bay
St Peter's, North Augusta
St Philips, Milford
St Stephen's, Bedford Mills
St Thomas', Belleville
St Thomas', Kingston
Deanery:
Please Select
Frontenac
Hastings
Quinte
Leeds-Grenville
Email
example@example.com
Type a question
Employee of diocese
Volunteer of diocese
Please provide 2 of the following government issued photo ID documents:
Driver's License
Permanent Resident Card
Possession and Acquisition Licence (PAL)
Canadian National Institute for the Blind Card
Military Family Identification Card (MFID)
Military Employment
Indian Status Card
Canadian Citizen Card
Passport
Federal, Provincial or Municipal Identification Card
Health Card with Photo
1. Attach scanned PDF copies or high quality images of the above selected photo ID. 2. Attach your completed ExpressChek Consent Form.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Date
-
Month
-
Day
Year
Date
Submit
Should be Empty: