Application for Electoral Roll

X Electoral Roll Application Form Icon

Please complete the form below taking note of the instructions. Fields where the titles are in bold text must be completed. For more information please see the notes which are available via the link at the bottom of the page.

APPLICATION FOR ENROLMENT ON THE CHURCH ELECTORAL ROLL 2025

Parish of (select)
Surname
Christian Names
Preferred title (if any)
Street Address
Town/village (eg Milborne Port)
Postcode
Email Address
Phone (optional)

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

1A		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		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:

Date: 16 March 2025

Download Electoral Roll Application Notes