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New Members or Update Details Form
This form is for new members to Papakura Anglican Church or for those whose details have changed within the same household address.
You may use this form to be removed from our database.
Date
New, Updating or Deleting?
*
All fields with a * are mandatory. If you are unable to fill in this please contact the Office 09 299 8086.
I am a new member
I am updating my details
I wish to be removed from the Parish Roll
Persons name
*
First name
Last name
Show on directory ?
Prefer to be known as
*
Gender
*
Male
Female
Date of Birth
This allows us to identify potential at risk people
Or enter year of birth
Email address
This will be used to communicate with you.
Show on directory ?
Home phone
Show on directory ?
Cell phone
Show on directory ?
Preferred contact method
Email
Text
Letter
Phone
Facebook
Slack
Cell
Other Communication
Please indicate other forms of contact you are happy for us to use to contact you. Note: Ticking any of these gives your express permission to contact you. This can be changed at any time by ticking the remove me tick box at the top and then ticking the apps you wish to be removed from.
I allow the following Apps to be used as communication
If you wish to allow us to contact you via the listed forms of communication.
I wish to be removed from the following Apps
If you wish to no longer be contacted via these forms of communication
WhatsApp
Messenger
FaceBook
Instagram
Other
Please use this to help us understand which communication Apps you use.
+ Add family member
- Remove family member
Persons address
*
Please ensure you include a postcode
Address line 1
Address line 2
Address line 3
Address line 4
Town/Suburb
City
Postcode/Zip
Show on directory ?
Removal from Roll
Please indicate your reason for removal
I no longer live in the area
I no longer wish to receive communications from you
I have received an unsolicited email
Member is deceased
Other reason - please state
Please check the highlighted fields
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