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The Episcopal Church
The Anglican Communion
Please tell us about yourself:
(* denotes required fields)
Date of Application:
Year:
Parish I.D#:
Church
Address
Suite
City
State
Zip
Office Phone *
Office Fax
Parish Website
Parish Email *
Continued below...
Parish Leadership
Click on each clergy, staff or volunteer position that applies to your parish, and a form will open for you to complete. Please continue this for all positions that apply to your parish.
Rector, Vicar, or Clergy In Charge
First Name 1
Last Name
Title
Address
Suite
City
State
Zip
Home Phone
Office Phone
Email
Assistant Clergy-1
First Name 2
Last Name
Title
Address
Suite
City
State
Zip
Home Phone
Office Phone
Email
Assistant Clergy-2
First Name 3
Last Name
Title
Address
Suite
City
State
Zip
Home Phone
Office Phone
Email
Assistant Clergy-3
First Name 4
Last Name
Title
Address
Suite
City
State
Zip
Home Phone
Office Phone
Email
Assistant Clergy-4
First Name 5
Last Name
Title
Address
Suite
City
State
Zip
Home Phone
Office Phone
Email
Assistant Clergy-5
First Name 6
Last Name
Title
Address
Suite
City
State
Zip
Home Phone
Office Phone
Email
Assistant Clergy-6
First Name 7
Last Name
Title
Address
Suite
City
State
Zip
Home Phone
Office Phone
Email
Warden-1
First Name 8
Last Name
Title
Address
Suite
City
State
Zip
Home Phone
Office Phone
Email
Warden-2
First Name 25
Last Name
Title
Address
Suite
City
State
Zip
Home Phone
Office Phone
Email
Treasurer
First Name 9
Last Name
Title
Address
Suite
City
State
Zip
Home Phone
Office Phone
Email
Clerk
First Name 10
Last Name
Title
Address
Suite
City
State
Zip
Home Phone
Office Phone
Email
Music director/organist
First Name 11
Last Name
Title
Address
Suite
City
State
Zip
Home Phone
Office Phone
Email
Parish Administrator
First Name 12
Last Name
Title
Address
Suite
City
State
Zip
Home Phone
Office Phone
Email
Bookkeeper/Fin.Sec'y
First Name 13
Last Name
Title
Address
Suite
City
State
Zip
Home Phone
Office Phone
Email
Parish Historian
First Name 14
Last Name
Title
Address
Suite
City
State
Zip
Home Phone
Office Phone
Email
Parish Secretary
First Name 15
Last Name
Title
Address
Suite
City
State
Zip
Home Phone
Office Phone
Email
Christian Formation
First Name 16
Last Name
Title
Address
Suite
City
State
Zip
Home Phone
Office Phone
Email
Children's Ministry / birth-grade 5
First Name 17
Last Name
Title
Address
Suite
City
State
Zip
Home Phone
Office Phone
Email
Youth Ministry / grades 6-12
First Name 18
Last Name
Title
Address
Suite
City
State
Zip
Home Phone
Office Phone
Email
Young Adult Ministry / College - 30s
First Name 19
Last Name
Title
Address
Suite
City
State
Zip
Home Phone
Office Phone
Email
Adult Christian Formation
First Name 20
Last Name
Title
Address
Suite
City
State
Zip
Home Phone
Office Phone
Email
Outreach/Mission
First Name 21
Last Name
Title
Address
Suite
City
State
Zip
Home Phone
Office Phone
Email
Other position-1
First Name 22
Last Name
Title
Address
Suite
City
State
Zip
Home Phone
Office Phone
Email
Other position-2
First Name 23
Last Name
Title
Address
Suite
City
State
Zip
Home Phone
Office Phone
Email
Other position-3
First Name 24
Last Name
Title
Address
Suite
City
State
Zip
Home Phone
Office Phone
Email
1. Contribution to an accredited seminary in the prior year.
$
Seminary name(s)
2. Send statements and bills to church?
Yes
No
If no, where?
3. Does your parish have a relationship with a parish in Colombia or the Caribbean or with a parish/diocese elsewhere in the Diocese of Connecticut, or the Episcopal Church or the Anglican Communion?
Yes
No
If so, what is it? (Where, what, with whom, any partners?)
Enter the code shown above
More Info
Why Do I Need to Enter This Code?
By entering the code you see in the box, you help us prevent automated registrations. This reduces system loads and ensures better performance of our services.
If no image appears, please make sure your browser is set to display images and try again. If you are not sure what the code is, make your best guess. If you guess incorrectly, you will have an opportunity to enter a different code on the next screen. Visually impaired or blind users: please contact us for assistance.
Please note that you will not be able to print this form once it has been submitted.
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The Episcopal Diocese of Connecticut | 1335 Asylum Ave | Hartford, CT 06105 | Tel. 860-233-4481, 800-842-0126 (in CT)
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