Please provide the phone number of the deacon this membership is for:*

ONLY FOR THOSE WHO ARE PAYING FOR SOMEONE ELSE: We require the following 3 pieces of information to complete this application: (the 3 questions follow the empty box immediately below) [If you are purchasing your own membership, please drop down to the next section that follows the 3 questions and continue from there.]

1. The deacon's full title and name?

2. The deacon's full address?

FOR ALL MEMBERSHIPS: Please provide the following 2 pieces of information (required): (the 2 questions follow the empty box immediately below)

1. The deacon's parish name and parish's full address?*

2. The deacon's diocese/ecclesiastical province?*

FOR ALL MEMBERSHIPS: We would be pleased if you could provide the following 5 pieces of optional information, for our demographic purposes: (the 5 questions follow the empty box immediately below)

1. The deacon's principal diaconal ministry?

2. The deacon's profession or regular employment?

3. The deacon's date of birth?

4. The deacon's diocese name?

5. The deacon's date of ordination?

Is this a new membership or a renewal?*

I give permission for Anglican Deacons Canada to contact me periodically for ADC purposes via e-mail or other means.*

Other Information or comments (if any)

You will see that in the payment details (below) there is a box that shows a 15% amount to support the Zeffy platform. This is something Zeffy puts there and that we cannot change. It is completely OPTIONAL so you can choose to change the amount to what you wish by selecting OTHER in the drop-down box.