BAY OF QUINTE CONFERENCE - THE UNITED CHURCH OF CANADA
APPLICATION TO OBTAIN/RETAIN A MARRIAGE LICENCE
(For Retired/Retained Ministry Personnel)

(Please print)
PART 1: (to be filled out by the person wishing to be licensed)

I, ______________________________, ministry personnel within The United Church of Canada, do hereby request through the ______________________________ Pastoral Charge (or Presbytery- recognized ministry) and ______________________________ Presbytery that I be given permission to obtain/retain a licence to perform marriages within the Province of Ontario according to the rites and usages of The United Church of Canada. I acknowledge that this licence will be applicable for the duration of my covenanted ministry with this pastoral charge/Presbytery-recognized ministry.

Signed:__________________________________________        _____________________
          Person applying to obtain/retain a licence to marry            Date

Home Address: _______________________________________________________________

Former marriage licence # (if applicable): ________________

PART 2: (to be completed by the congregation or Presbytery-recognized ministry)

A motion was passed on __________, 20___ by the ______________________________ (Official Board, or its equivalent) of the ______________________________ Pastoral Charge (or Presbytery-recognized ministry) within ____________________ Presbytery requesting that ______________________________ be granted a licence to perform marriages within the Province of Ontario according to the rites and usages of The United Church of Canada. We certify that s/he is fulfilling a pastoral function which would be aided by the granting of such a licence. We further affirm that s/he is in a covenanted relationship with this pastoral charge/Presbytery-recognized ministry.

Signed:__________________________________________          ____________________
          Secretary of Official Board (or its equivalent)                       Date

PART 3: (to be completed by the Presbytery of which the person is a member)

A motion was passed on ___________, 20___ by ________________________________ Presbytery supporting the application of ____________________________________ and the ___________________ ______________________________ Pastoral Charge (or Presbytery-recognized ministry) for him/her to be granted a licence to perform marriages within the Province of Ontario according to the rites and usages of The United Church of Canada. The Presbytery certifies that s/he is fulfilling a pastoral function on the ____________________________ Pastoral Charge/Presbytery-recognized ministry which would be aided by the granting of such a licence. We further affirm that s/he is in a covenanted relationship with this pastoral charge/Presbytery-recognized ministry.

Signed: _________________________________________            ___________________
          Secretary of Presbytery                                                     Date

(Instructions: After all three parties have filled out this form, return it to - Bay of Quinte Conference, 67 Mill St., Box 700, Frankford, Ontario, K0K 2C0)