If you wish to be included in the congregational roll of this church, please fill in this form. In the weeks leading up to the AGM the rolls of this church are being revised. Please fill in full contact details if you are part of this congregation, and tick the box if you have received Communion in the last twelve months in this church or another Anglican/Episcopal congregation. Please note that providing information for the Congregational Roll indicates consent to St Mary’s Cathedral retaining and processing the information for Cathedral use and to sharing this information with the Bishop and Dean of the diocese as provided by Resolution under Canon 42 of the Code of Canons. The information will be kept confidential and not released to any other organisation without express permission. The Cathedral’s Privacy Policy can be viewed on the Cathedral website – www.thecathedral.org.uk

Each adult aged 16 and over should complete a separate form.

If there are young people under 16 in your household please add their details in the box provided below. Note that Children aged 12 and over may sign and consent on their own behalf, otherwise you are consenting on their behalf.

If you are human, leave this field blank.

Name

First Name *

Last Name *

Address

Street Address

Address Line 2

City

Post Code

Contact Details

Home telephone number

Mobile telephone number

Email Address *

Communicant *

I am a communicant

I am not a communicant

Other details

Children - names and dates of birth

Please use this box to list names and dates of birth of children

Optional Message

Please use this box for any optional message that you wish to add.

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