Clergy Disciple Measure - Form 1c | The Church of England

Clergy Disciple Measure - Form 1c

To the President of Tribunals

When your application is received by the President of Tribunals your name will be disclosed to the person your complaint is about (“the respondent”), but you may request that your contact details should not be disclosed.

Your full name

Address

Address 2

City/Town

ZIP/Postal Code

Phone number

This is optional but could be helpful for the President to have.

Email address

This is optional but could be helpful for the President to have.

I request that my contact details should not be disclosed to the respondent for the following reasons

If you tick the box you must give reasons – your contact details would then be disclosed to the respondent only if the President is so directed.

Reasons for not disclosing my contact details