PROVINCE OF CANTERBURY Application for Permission under the Overseas and Other Clergy (Ministry and Ordination) Measure 1967 1. (a) Applicant's Surname ) …………………………………………………………………… (b) Full Christian names ) …………………………………………………………………… (c) Address ) ..…………………………………………………………………. )..………………………………………………………………….. (d) E-mail address ) …………………………………………………………………… 2. Date of birth ) ..…………………………………………………………………. 3. (a) Date and place of Ordination as Deacon ) ) ..…………………………………………………………………. (b) Name of Ordaining Bishop and See name ) ) ..…………………………………………………………………. *Please attach a copy of your Letters of Orders 4. (a) Date and place of Ordination as Priest ) ) ..…………………………………………………………………. (b) Name of Ordaining Bishop and See name ) ) ..…………………………………………………………………. *Please attach a copy of your Letters of Orders 5. Name of Bishop of diocese in which ) you currently serve ) ..…………………………………………………………………. *Please attach a letter of recommendation from your bishop indicating that you are in good standing. 6. Date of arrival in England ) ..…………………………………………………………………. 7. Reasons for coming to this country ) ..…………………………………………………………………. 8. (a) If you wish to minister full-time in ) England have you obtained entry ) ..…………………………………………………………………. clearance to the United Kingdom as a ) minister of religion? (For details ) apply to the British Embassy, High ) Commission or other British ) Diplomatic Mission in the ) country in which you are living.) ) (b) For what period of time do you ) have entry clearance? ) ..…………………………………………………………………. 9. For what period of time are you seeking ) permission ) ..…………………………………………………………………. (First applications are normally granted for a maximum period of three years). 10. Name of Bishop of English Diocese in ) which you intend to officiate ) ..…………………………………………………………………. *Please attach a letter indicating that the Bishop is willing to give you permission to officiate in the diocese. 11. Have you applied to the Archbishop of ) York for permission to officiate in the ) ..…………………………………………………………………. Province of York? If so, with what result? ) *This application will not ordinarily be considered unless ALL these documents When completed, this application and are attached. the attached documents should be sent to: The Provincial Registrar, Legal Date: Office, Church House, Great Smith Signature: Street, London SW1P 3AZ .