Custom Forms | Electoral Roll Enrolment Form

Chaplaincy of Aquitaine

Thank you for taking the time to complete this form, we are delighted to welcome you as a member of the Chaplaincy of Aquitaine.

a) Personal information

Title

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Name *

First name *

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Middle name(s)

Surname *

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Address *

Address 1 *

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Address 2

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Address 3

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Town *

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County *

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Postcode *

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Country *

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Email *

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Mobile

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b) Chap-Aid

I wish to become a member of Chap-Aid (French Association Loi 1901) *

*Chap-Aid was started to allow the Chaplaincy to make donations to charities. Your membership implies your support for Christian charitable giving, but there are no direct financial implications.

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c) Declaration Part 1

I declare that I am baptized *

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I am a lay person (i.e. not clergy) *

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I am aged 16 or over *

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d) Declaration Part 2 - "I DECLARE THAT..." (please answer ONE of the following 3 questions)

1) I am a member of the Church of England (or of a Church in communion with the Church of England) and have my name entered on the electoral roll of a parish or chaplaincy in the Provinces of Canterbury or York.

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2) I am a member of the Church of England (or a Church in communion with the Church of England) and I have habitually attended public worship in the chaplaincy during the period of six months prior to enrolment.

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3) I am a member in good standing of a Church not in communion with the Church of England which subscribes to the doctrine of the Holy Trinity and also declare myself to be a member of the Church of England and I have habitually attended public worship in the chaplaincy during the period of six months prior to enrolment.

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e) Declaration of Truth

I declare that the above answers are true and I apply for inclusion on the Electoral Roll for the Chaplaincy of Aquitaine, France. *

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Electoral Roll Enrolment Form

a) Personal information

b) Chap-Aid

c) Declaration Part 1

d) Declaration Part 2 - "I DECLARE THAT..." (please answer ONE of the following 3 questions)

e) Declaration of Truth

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Electoral Roll Enrolment Form

a) Personal information

b) Chap-Aid

c) Declaration Part 1

d) Declaration Part 2 - "I DECLARE THAT..." (please answer ONE of the following 3 questions)

e) Declaration of Truth

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