ELECTORAL ROLL APPLICATION FORM Please fill in the form below to join the Electoral Roll of St Luke’s Bath. If you want to know more or need any further help please see our guidance notes here, or email us here. First Name * Last Name * Email Address, excluding postcode * Postcode Declarations I declare that * I am baptised, I am a lay person, and I am aged 16 or over I declare that * (Tick one option) 1. I am a member of the Church of England (or of a Church in communion with the Church of England) and am resident in the parish of St Luke's. 2A. I am a member of the Church of England or of a Church in communion with the Church of England, am not resident in the parish, but have habitually attended public worship in the parish during the preceding six months. . 2B. I am a member of the Church of England or of a Church in communion with the Church of England, am not resident in the parish and would have habitually attended public worship in the parish during the preceding six months but was prevented from doing so because... (provide reason below) 3A. I am a member in good standing of a Church which is not in communion with the Church of England but subscribes to the doctrine of the Holy Trinity, and am also a member of the Church of England and have habitually attended public worship in the parish during the preceding six months. 3B. I am a member in good standing of a Church which is not in communion with the Church of England but subscribes to the doctrine of the Holy Trinity, and am also a member of the Church of England and would have habitually attended public worship in the parish during the preceding six months but was prevented from doing so because... (provide reason below) Further information If you have ticked box 2B or 3B please provide further information here Signature I declare that * The above answers are true and I apply for inclusion on the church Electoral Roll of the parish. In lieu of a signature, please enter your initials below Thank you for your submission. Applications will be reviewed and the updated Roll will be published ahead of the APCM in May.
