• Application for Enrolment on the Church Electoral Roll of the Parish of St Mary the Virgin, Deane

  • I declare that:

    1. I am baptised, am a lay person and am aged 16 or over (or become 16* on ___________)
  • All applicants must tick only one of 2A, 2B and 2C:*
  • If you have ticked 2B or 2C, you must choose one of the options below:
  • I declare that the above answers are true and I apply for inclusion on the Church Electoral Roll of the parish.

  • Date
     - -
    2 digit day, 2 digit month, 4 digit year
  • Optional information

    If you have not recently provided us with the following information, or would like to update any of your preferences, please complete the questions below:
  • Emergency contact

    If you would like us to have an emergency contact number on record for you please complete this section
  •  -
  •  -
  • Contact preferences

    Details of the way in which we can contact you
  • Phone
  • Text / WhatsApp:
  • Email
  • Post
  • Are you happy for us to share your contact details with other church family members if appropriate?
  • If you don't already, would you like to receive Church Family News by email every week?
  • Photograph and video consents

    Consent relating to use of videos and photographs which may include you
  • I consent to photographs and videos being taken by Deane Church staff or other nominated person
  • I consent to videos and photographs which include me being used on Deane Church website
  • I consent to videos and photographs which include me being used on other publicity
  • 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, by
    (a) choosing the first or second set of words
    (b) if choosing the second, briefly state the reason for not having worshipped as mentioned.


    4. If you have any problems with this Form, please approach Rev'd Terry Clark, Rev'd André Adefope or Margaret Rutter, 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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