Personal Details

Your details

Payroll NumberIf you are not on Payroll please use Identification Number provided, or if you do not yet know your payroll number please leave blank

First Name

Middle Name(s)

Last Name

SexMaleFemaleOther

Date of Birth

Mobile Number

Work Email Address

Personal Email Address

Street Address

Suburb

StateACTNSWNTQLDSATASVICWA

Postcode

My postal address is different to my residential address

YesNo

Postal Address

Postal Address

Suburb

StateACTNSWNTQLDSATASVICWA

Postcode

Silent Details

The personal information you provide will be used by the Registry only for the purposes for which it is collected in accordance with our Privacy Policy.

If you are in a ministry role your contact information (mobile, email, address) will be used for the purposes of diocesan & parish contact details and be made available more broadly.

If you do not want your contact information to be made available to others, please indicate below. This means the Registry Office will not distribute your information without your permission.

Please keep the following contact information silent

MobileWork EmailPersonal EmailStreet AddressPostal Address

Emergency Contact

Emergency Contact Name

Phone Number

Address

Relationship

Ordination

Are you ordained?YesNo

Ordination details

I am aDeaconPriestBishop

Deacon: Date ordained

Deacon: Diocese ordained

Priest: Date ordained

Priest: Diocese ordained

Bishop: Date consecrated

Bishop: Diocese consecrated

Category

In what capacity are you engaged with the Anglican Dicoese of Bendigo?Active ClergyPTO ClergyLay Licenced MinisterRegistry StaffParish EmploymentOtherI don't know

Acknowledgements

The Anglican Diocese of Bendigo only discloses personal information for the purpose it was collected (primary purpose) unless the person concerned has consented, or a secondary purpose is related to the primary purpose and a person would reasonably expect such use or disclosure.

For more detail you can read our Privacy Policy

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