APPLICATION FOR ENROLMENT ON THE CHURCH ELECTORAL ROLL 2026
  

Parish of (select)	MP
Surname	gsfgfdg
Christian Names	sdfgfdsg
Preferred title (if any)
Street Address	Davlen Bathwell Lane
Town/village (eg Milborne Port)	Milborne Port
Postcode	DT9 5JD
Email Address	sharplessgraham@gmail.com
Phone (optional)

1: I declare that (please check only one box from options A or B)

1A	X	I am baptised, am a lay person, and aged 16 or over.
1B		I am baptised, am a lay person, and become 16* on

 *Those who become 16 in the next twelve months may complete the form and become eligible to be entered on the roll on their sixteenth birthday.

 2: I declare that (please check only one box from options A, B or C)

2A	X	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.
2B*		I am a member of the Church of England or of a Church in communion with the Church of England, am not resident in the parish, but have habitually attended** public worship in the parish during the preceding six months.
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.

** or would have habitually attended but was prevented from doing so because 

 

*If you tick 2B or 2C in circumstances where a new Roll is being prepared and you have not attended church regularly during the last six months, you must fill in the space above giving your reason.

I agree that my email address can be used to send me the Pew News newsletter. Note that you can unsubscribe at a later date if you do not wish to continue to receive it.

I declare that the above answers are true and I apply for inclusion on the church electoral roll of the parish.

Signed: gdfasdfdsaf

Date: 2026-02-21