Electoral Roll Form

Below you will find an online Electoral Roll form to fill in.

If you prefer to print out the form please click on the button below to download the form. This form can then be printed and signed then either posted or scanned and emailed.

2021 Electoral Roll Form Revision Notice
Electoral Roll Form PDF download

Your full name

Your full address

I declare that...

* Those who become 16 during the next twelve months may complete the form and become eligible to be entered on the roll on their sixteenth birthday.

I declare that the above answers are true, and I apply for inclusion on the Church Electoral Roll of the parish.


  1. The only Churches at present in communion with the Church of England are other Anglican Churches and certain foreign Churches.
  2. Membership of the Electoral Roll is also open to members in good standing of a Church not in communion with the Church of England which subscribes to the doctrine of the Holy Trinity where those members are also prepared to declare themselves to be members of the Church of England.
  3. Every six years a new roll is prepared and those on the previous roll are informed so that they can re-apply. If you are not resident in the parish but were on the roll as an habitual worshipper and have been prevented by sickness or absence or other essential reason from worshipping for the past six months, you may write “would” before “have habitually attended” on the form and add “but was prevented from doing so because…” and then state the reason.
  4. If you have any problems over this form, please approach the clergy or lay people responsible for the parish, who will be pleased to help you.
  5. In this form “parish” means ecclesiastical parish.

Additional Information
(This is not part of the statutory application form)

It would be very helpful for pastoral and communication purposes to have your email address and telephone number, although this is optional.

This information, if given, will not appear on the published Electoral Roll. The information will be used only to facilitate communication with you within the Church, for example by your parish priest or bishop, and will not otherwise be shared with third parties.