Chaplaincy

Name (optional)

Email (optional)format

Prayer requestrequired You may wish to give us some details about the situation or person to be prayed for or having given your name you may simply leave the request box blank.
Any information which you provide on this form is solely for the purpose of prayer. The information provided will not be disclosed by the Chaplains without your consent.

Data Protection*required
I understand that the personal data relating to myself or any other individuals which I have provided on this form may be stored in paper and/or electronic form for a period of one month only, and in accordance with University of East London's policies on Data Protection and with the provisions of the Data Protection Act (1998).

Antispam*requiredincorrect, try again
Please type in the two words displayed on the right (if you are unable to read the words please press for alternative wording or for an audio version.) Please note; the Antispam message must be typed in correctly otherwise the text within the fields will be lost

The form is incomplete, please re-check the form and try again