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Church Membership
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Personal Details
Title
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Mr
Mrs
Miss
Ms
Dr
Rev
Name
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Surname
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Address 1
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Address 2
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Postcode
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Phone
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Communications Preferences
Email
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Mobile
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Contact from ministry team by
Email
Phone
Can share with others
Email
Phone
Add to email news
Yes
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Next of Kin
Emergency Contact Name
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Emergency Contact Number
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Electoral Roll
For inclusion on the ER, I am baptized and
over 16
will soon turn 16 ** keep note to add at this date **
ER qualification
Resident
Non-resident worshipper
Other Trinitarian worshipper
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Gift Aid Declaration
Gift Aid can be claimed by St Peter's
Yes
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Signed
Signature Date
MM
/
DD
/
YYYY
Record added by
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ER
Vicar
Warden
Admin
Misc.
On PCC
Yes
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