Registration – St.Marys Jacobite Syrian Orthodox Church Basildon

Event Registration Form (#3)

ST. MARY’S JACOBITE SYRIAN ORTHODOX CHURCH

(Under the Holy Apostolic See of Antioch and All the East)

Basildon, United Kingdom

UK Charity Registration No: 1209689

First Name

Middle Name

Last Name

Address In the U K

Contact Number

Marital Status

Spouse Name

Home Parish in India/Previous church

1. The above information is true and in the best of my knowledge; please enroll our family as the members of

St. Marys Jacobite Syrian Orthodox Church, Basildon, United Kingdom. We here by agree to accept

and follow the faith & tradition of the Syrian Orthodox Church (Jacobite) and abide by the constitution of

St.Marys Jacobite Syrian Orthodox Church Basildon,United Kingdom

2. We accept the supremacy of His Holiness Moran Mor Ignatius Aphrem Il, the Patriarch of Antioch & All the

East, Supreme Head of the Universal Syrian Orthodox Church and we will be loyal and obedient to His

Holiness Moran Patriarch and his successors.

3. I am fully aware that deviating from either the objectives or the statement of faith in

St. Mary’s Jacobite Syrian Orthodox Church bylaw will result in the cancellation of this membership.

Authorization and Signature:

Name of the Applicant

Date / Time

Notes

The decision and approval of the Managing Committee/General Body:

Membership: Full Membership/ Associate membership with effect from

Vicar’s Signature

Name

Secretary's Signature

Name

Data Protection: As part of this agreement, you consent to St. Marys Jacobite Syrian Orthodox Church for

holding and processing data relating to the service being provided for legal, personnel, administrative and

management purposes. Data will be managed in line with the requirements of the Data Protection Act 2018.