ONLINE DATA COLLECTION FORM

Please update my details and data consent for the Circuit Directory.

Circuit/Church Directories are only circulated to those people listed within the directory and are not available to the general public or available anywhere on-line.

If you see a copy on public display in a church, please remove and report this to the Circuit Administrator. Thank you.

I confirm that I have read and understood the Data Protection relating to my details *

Yes

I give my consent to be included in the following directory - use the drop down box *

I give my consent to

Be informed of news and events

I give my consent to

Be contacted by District Officers/Connexional Team

I give my consent to

Be contacted about specific fund raising events.

I would prefer to be contacted by: *

Phone

Mr/Mrs/Rev *

Christian Name *

Surname *

Your Addess *

Town *

Post Code *

Email *

Telephone *

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