Membership Application Form
* indicates required information
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Choose Title. If not listed, select 'Other': * |
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Enter Title only if 'Other' selected above: |
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First Name: * |
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Last Name: * |
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Suffix: |
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E-Mail address: * |
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Primary Phone. If no land-line phone, enter Mobile no: * |
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Mobile Phone: |
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Select your Diocese: * |
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Job Title or Role: * |
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Work/office location, if different to address entered above: |
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Address at: (Home or Work) * |
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Address, Street and Suburb/Village: * |
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POSTAL TOWN/CITY: * |
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Choose County, If not LONDON, BIRMINGHAM or MANCHESTER: |
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Post Code: * |
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A few words about your Ministry, please: * |
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If any, web-link to page for your Ministry: |
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If any, web-link to your Photo: |
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Name and/or E-Mail of person who introduced you to FPE: * |
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current Membership Year: * |
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Membership Fee and Type: * |
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We will be contacting you soon. Thank you for applying for membership.