Church Membership
Personal Details
Title
Name
Surname
Address 1
Address 2
Postcode
Phone
Communications Preferences
Email
Mobile
Contact from ministry team by
Can share with others
Add to email news
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Next of Kin
Emergency Contact Name
Emergency Contact Number
Electoral Roll
For inclusion on the ER, I am baptized and
ER qualification
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Gift Aid Declaration
Gift Aid can be claimed by St Peter's
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Signed
Signature Date
MM
/
DD
/
YYYY
Record added by
Misc.
On PCC
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