*(denotes required field)

First Name: *

Last Name: *

Address 1 *

Address 2

Town

City

Postcode

Home Telephone Number

Work Telephone Number

Mobile Telephone Number

---

How long have you lived in the Parish of St Boniface

Have you signed a Covenant with St. Boniface:

Yes
No

If “No”,would you be interested to know how it benefits the Parish?:

Yes
No

Do you know an elderly or housebound person who needs a visit?:

Yes
No

If “Yes”, please give details

Are there any special skills or experience you can offer to the Community? E.g:

Reader
Special Minister
Usher
Music
Choir
Driver
Visiting
Youth

Please tick as many as you need

What can the Parish offer you?

---

The purpose of this form is to keep our records up to date. Please include all members of your household at this address. Thank you.

Person 1

TITLE,FAMILY NAME,MARITAL STATUS,FIRST NAME,RELIGION,DATE OF BIRTH,OCCUPATION / SCHOOL

Person 2

TITLE,FAMILY NAME,MARITAL STATUS,FIRST NAME,RELIGION,DATE OF BIRTH,OCCUPATION / SCHOOL

Person 3

TITLE,FAMILY NAME,MARITAL STATUS,FIRST NAME,RELIGION,DATE OF BIRTH,OCCUPATION / SCHOOL

Person4

TITLE,FAMILY NAME,MARITAL STATUS,FIRST NAME,RELIGION,DATE OF BIRTH,OCCUPATION / SCHOOL

Person 5

TITLE,FAMILY NAME,MARITAL STATUS,FIRST NAME,RELIGION,DATE OF BIRTH,OCCUPATION / SCHOOL