EPCC Registration Form

Surname / Date of Birth
First Name / Ordination Year Deacon
Other names / Priesting Year
Address / Family and spouse if applicable
Email address / Tradition e.g. Evangelical/Charismatic/
Catholic
Phone number / Mobile
Education – Theological college, academic qualifications, professional/technical training qualifications
Main Occupations prior to ordination detailing main roles in reverse chronological order
Experience of Leadership within a church prior to ordination
Do you have any family reasons for staying in a particular area?
Do you have particular views we need to be aware of
E.g., women’s ministry, charismatic issues, baptism, (re)marriage, human sexuality?
Positions held since ordination in reverse chronological order include key national church or diocesan responsibilities
Post / Parish / Diocese / From To
Areas and situations etc. where you would be willing to serve, ( see page 3 for area definitions of area)
Location / Parish Features / Type of Parish / Worship / Type of post / Minister in
North East / Cell Church / City / All age / Incumbent / Mixed Team
North West / ChoralTradition / Country Town / BCP / Daughter
Church / Non Evangelical
Church
East Midlands / Church Plant / InnerCity / Common
Worship / Team Vicar / Overseas
West Midlands / Church Schools / Rural / Family / Associate Vicar / MissionAgency
South Midlands / EthnicGroups / Commuter
Village / Informal / Team Rector
South East / Evangelism / Town Centre / Renewal / House for Duty
Post
London / Home Groups / Urban / Traditional / Part time Post
South West / Music Group / Suburban / LEP
East Anglia / Retired /
Please fill in the table entering
2 for any item to which you are drawn
1 where you are open to minister
0 where you feel unable to minister / Pioneer/fresh expression role
Scotland / Students / Chaplain
(What sort?)
Youth &Children
State the main emphasis of your ministry for last 5 years and some indication of what has and hasn’t been achieved
What are you realistically looking for in terms of your next post?
Health / Do you Drive?
Location / Diocese
North East / Bradford
Durham
Newcastle
Ripon and Leeds
Sheffield
Wakefield
York
North West / Blackburn
Carlisle
Chester
Liverpool
Manchester
East Midlands / Derby
Leicester
Lincoln
Peterborough
Southwell
West Midlands / Birmingham
Coventry
Hereford
Lichfield
Worcester
South Midlands / Gloucester
Oxford
St Albans
London / London
Southwark
Chelmsford (West of Diocese)
East Anglia / Ely
Norwich
St Edmundsbury and Ipswich
South East / Canterbury
Chelmsford (East of Diocese)
Chichester
Guildford
Portsmouth
Rochester
Winchester
South West / Bath and Wells
Bristol
Exeter
Salisbury
Truro

Note

The Boxes on the form are locked so you cannot write any more than the box allows.

Please return the form to

Many thanks