Crockford biographical details form, GDPR permissions forms and Privacy Notice

1. Crockford Biographical Details form

Please use this form to provide us with the information we require to maintain a record within the Crockford database and, where applicable, an entry in Crockford’s Clerical Directory (our printed publication and the subscription service at: www.crockford.org.uk). If you have previously provided your details there is no need to complete this form again.

Please be aware that the information given on this form will be published (provided you give us your consent on the GDPR form on page 2) unless you specifically ask us not to publish it. You can read our privacy policy here, or on pages 3 and 4 of this survey.

If you have any problems completing this survey, all the relevant documents are also available on the Church of England website https://www.churchofengland.org/more/clergy-resources/crockfords-clerical-directory/appearing-crockford

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* 1. What is your surname?

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* 2. What is your preferred title?

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* 3. What are your Christian names? (full legal forenames please)

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* 4. Do you have an alternative name? (this can be a maiden name, a name 'in religion', or a name used in preference to a Christian name).

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* 5. What is your gender?

Male

Female

Prefer not to say

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* 6. What is your date of birth?

Date

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* 7. What is your date of ordination as deacon?

Date

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* 8. What is your date of priesting? (If applicable)

Date

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* 9. Please provide your address details (post-ordination if currently in theological education)

Address

Address 2

City/Town

Postal Code

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* 10. Please provide your preferred contact telephone number(s) and e-mail address(es)

Landline

Mobile

E-mail address

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* 11. Which theological education institution(s) did you attend, and when?

Institution

Year of entry

Qualification (if applicable)

Year awarded

Institution

Year of entry

Qualification (if applicable)

Year awarded

Institution

Year of entry

Qualification (if applicable)

Year awarded

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* 12. Do you have any other educational qualifications?

Awarding body (and college if appropriate)

Qualification

Year awarded

Awarding body (and college if appropriate)

Qualification

Year awarded

Awarding body (and college if appropriate)

Qualification

Year awarded

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* 13. Please provide details of your appointment(s) post-ordination (please include dates, benefice/parish name, post, and diocese)

Appointment

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* 14. Any other comments or things you would like us to know? If you would like a particular piece of information withheld from publication let us know here.

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25% of survey complete.