ELECTORAL ROLL APPLICATION FOR ENROLMENT ON 2013-2018 HTB ELECTORAL ROLL (NB Please do not complete this form if you have already signed up for the ER) Electoral Rolls are revised every six years and the current of Holy Trinity Brompton with St Paul Onslow Square HTB ER runs from 2013-2018. If you are eligible to be entered on the and St Augustine (Queen’s Gate) electoral roll (see declaration on form) and have not yet signed up, please complete and return this form to HTB as advised. Please do not complete this Please complete in BLOCK CAPITALS and see Notes on reverse of form form if you have already signed up for the current electoral roll. (NB Contact details will not appear on the published electoral roll)

Electoral rolls should provide a true indication of the real membership and Full name: ______strength of the Church, both locally and nationally. Putting your name on the roll is a way of saying “I belong”; it is an act of commitment to your local church Title (Mr/Mrs/Miss/Dr etc.) ______and to the Church as a whole. Joining the electoral roll opens up the way for greater involvement in the life of the Church, at , diocesan and national Full address: ______levels. You become entitled to vote at the Annual Church Meeting. With your name on the electoral roll the strength of the Church can be seen in your area, ______Postcode: ______and across . Tel ______(h) ______(w) ______(mob)

Notes E-mail ______1. To be eligible to be entered on the electoral roll you must have been baptised or christened. I declare that: 2. If your 16th Birthday falls in the next 12 months you may complete the 1. o I am baptised (or christened) form and become eligible to be entered on the Roll on your birthday. 2. o I am aged 16 or over (or become 16 on ______) 3A. in this form “parish” means parish of residence. To check your parish of 3. Please tick one of the following three boxes: residence church enter your post code on the achurchnearyou webpage. 3A o I am a member of the Church of England (or of a Church in communion 3B. The only Churches at present in communion with the Church of England are with the Church of England) and am resident in the parish. other Anglican Churches, and certain foreign Churches. 3B o I am a member of the Church of England (or of a Church in communion 3C. Membership of the Electoral Roll is also open to members in good standing with the Church of England) and, not being resident in the parish, I have of a Church not in communion with the Church of England, which subscribes to habitually attended public worship in the parish during the six months prior the doctrine of the Holy Trinity, where those members are also prepared to to enrolment.* declare themselves to be members of the Church of England. 3C o I am a member in good standing of a Church not in communion with *(ref 3B and 3C) If you are not resident in the parish but were on the roll as a the Church of England which subscribes to the doctrine of the Holy Trinity, habitual worshipper and have been prevented by sickness, or absence, or other and also declare myself to be a member of the Church of England, and I essential reason from worshipping for the past six months, you may write have habitually attended public worship in the parish during the period of “would” before “have habitually attended” on the form and add “but was six months prior to enrolment.* prevented from doing so because…” and then state the reason. I declare that the above answers are true, and I apply for inclusion on the The information on this form will be used only to facilitate communication Church Electoral Roll of the parish. within the Church Eg by your parish priest or bishop and will not otherwise be shared with third parties. Signed: ______Date: ______

If you have any questions about this form, please contact the Vicar’s Please hand in at Reception, post to Vicar’s Office, Holy Trinity Brompton, Office at Holy Trinity Brompton ([email protected]; 020 7052 0360) Brompton Road, London, SW7 1JA or email to [email protected]