IMPORTANT: If you have access to the internet, please would you use the online form at www.matvchurch.uk rather than this paper form as it will enable us to import your responses without having to type them into our database by hand. Permission for Mattishall & Tudd Valley churches to contact you (or withdraw permission). If you wish us to be able to contact you for things related to core activities of the benefice, e.g. pastoral care, please fill out and submit this form (note that if you wish to be informed by email of news and events posted on our website at MATVChurch.uk, please sign up there separately). For more information, please see our Data Privacy Notice on our website above. You can withdraw any consent given here by filling in your contact details below, ticking the "NONE - I AM WITHDRAWING MY CONSENT" tickbox, then clicking on the Submit button. If you have any queries, please do contact us at [email protected] or ring the Benefice Office. 1. First name (required) Please record your first name. 2. Surname (required) Please record your surname. 3. Communication methods (required) Please indicate all the methods we can use to contact you. Email Post Phone Text Message (SMS) NONE - I AM WITHDRAWING MY CONSENT 4. Email address Please record your email address if you are allowing us to email you. 5. Postal address Please record your postal address if you are allowing us to post to you OR if you ever want us to be able to visit you. 6. Post code Please record your post code if you are allowing us to post to you OR if you ever want us to be able to visit you. 7. Landline phone number Please record any landline phone number you wish us to have. Paper equivalent of online consent form.docx Page 1 of 2 IMPORTANT: If you have access to the internet, please would you use the online form at www.matvchurch.uk rather than this paper form as it will enable us to import your responses without having to type them into our database by hand. 8. Mobile phone number Please record any mobile phone number you wish us to have. 9. Main parish Please enter the parish you mainly identify with. East Tuddenham Hockering Mattishall North Tuddenham Welborne Yaxham All of them equally (yes, honestly) I don’t count myself as a member of any of the congregations, but would like to be contactable. 9. Second parish Please enter any second parish. East Tuddenham Hockering Mattishall North Tuddenham Welborne Yaxham 10. Old enough to give consent Please confirm that you are old enough to provide your own consent, i.e. that you are at least 13 years of age. I am old enough. Signed ……………………………………………………………………. Date ……………………………….. Please return this form to the Church Office, Church Rooms, Dereham Road, Mattishall, Dereham, NR20 3QA. Paper equivalent of online consent form.docx Page 2 of 2 .