Application for enrollment on the Church Membership List
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Parish of St. Simon, Southsea
Full Name *
Preferred Title (if any)
Full address *
Postcode *
E-mail address
I wish to receive Newsletters via e-mail *
I wish to receive occasional one-off messages via e-mail *
I am happy for my name to be used on the monthly Prayer Diary *
I declare that *
Signature (type name) *
Date *
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