Key Contact Personal Details for Synod and Presbytery use

Please fill out the following with the details you would like the Uniting Church SA to use when contacting you on official Church business.

Please fill out your name and at least two of the contact information fields.

The 2012 Privacy Amendment Act sets out how organisations should collect, use, store, secure and disclose personal information. Each contact field is followed by a choice of privacy options for that information.

Public - this information can be given out to anyone who asks.
Church use - this information will be available to ministers and church office bearers.
Synod use - this information is ONLY available to Presbytery and Synod staff.

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* 1. Title

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* 2. First Name

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* 3. Last Name

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* 4. Preferred Name

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* 5. Birth Date (this is always Church use only)

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* 6. Work Email

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* 7. Please indicate which privacy setting you would like attached to your work email.

Public - your work email can be given out to anyone who asks.

Church use - your work email will be available to ministers and official church office bearers.

Synod use - your work email is ONLY available to Presbytery and Synod staff.

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* 8. Work Phone (either landline or mobile)

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* 9. Please indicate which privacy setting you would like attached to your work phone.

Public

Church use

Synod use

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* 10. Home Phone

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* 11. Please indicate which privacy setting you would like attached to your home phone.

Public

Church use

Synod use

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* 12. Personal Mobile

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* 13. Please indicate which privacy setting you would like attached to your personal mobile.

Public

Church use

Synod use

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* 14. Personal Email

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* 15. Please indicate which privacy setting you would like attached to your personal email.

Public

Church use

Synod use

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* 16. Residential Street Address

Unit / Level

Street

Suburb / City State

Postcode

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* 17. Residential Address Privacy

Public

Church use

Synod use

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* 18. Postal Address Details (if different to above)

Line 1

Line 2

Suburb / City

State

Country

Postcode

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* 19. Please indicate which privacy setting you would like attached to your postal address.

Public

Church use

Synod use

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* 20. Please tell us what position(s) you hold or what roles you are designated as key contact and in what Church.

Position 1 (e.g. Property Officer- Yourtown Uniting Church.)

Position 2

Position 3

Position 4

Position 5

Position 6

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* 21. I can confirm that the above is true and correct.

Yes

Privacy Statement
All information collected on this form is managed in accordance with the Uniting Church SA Privacy Policy 2014. It has been collected for the primary purpose of communication and correspondence related to the activities conducted by the Presbytery and Synod of South Australia, and maintaining up to date Organisation and Office Bearer records, and/or compiling the Online Directory. It may also be used in relation to any authorised activities of other Synods or the Assembly of the Uniting church in Australia.

To view the complete Privacy Policy, please visit https://sa.uca.org.au/safe-church/privacy-policy
If you need clarification about what constitutes an authorised activity or you have any other privacy
related queries, please contact Rev Sue Page on (08) 8236 4217 or privacy@sa.uca.org.au