Request for Permission to Officiate (PTO)

Your FULL Name *

Where is your Canonical Residency? *

What is your ministry status? *

If you checked 'other' above, please provide details:

Your email address *

Your mailing address *

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Your phone number *

Parish / Church / Ministry you are connected with

Any other information you would like to share about your anticipated continuing ministry

A Criminal Records Check (CRC) carried out within the last 3 years is required for all licensed clergy / clergy with PTO. (You can apply for a Regina Police Check by visiting this link: https://www.reginapolice.ca/resources/criminal-record-check/). What's the date of your most recent CRC? (A copy must be held on your file at the Synod Office)

By submitting this form, I confirm that the Synod Office has all of the required documents on file. *

Yes

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Date of submission of this form *

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Request for Permission to Officiate (PTO)