Lay Chaplain Renewal Form
Please Note: Documents will be sent to the address you list below, please make sure you list the address where you want your documents to be sent. Renewal application cannot be sent by fax or e-mail.
Name: ____________________________________________________ Date: ________________
Address: ________________________________________________________________________
City: ____________________________ State: _______________ Zip Code:__________________
Home Phone (____) _______________________ Business Phone (___)_____________________
E-mail Address: __________________________________________________________________
Marital Status: [ ] Single [ ] Married [ ] Divorced [ ] Remarried [ ] Other
Hair Color: ____________ Eye Color: __________ Height: __________ Weight: ______________
I have been a member Since: Date: __________________________________________________
My member's ID Card Number is: ___________________________________________________
My membership expires or expired on: _______________________________________________
In Case of an emergency notify: ____________________________________________________
Relationship _______________________________ Phone: ______________________________
Chaplain Fellowship Ministries Holds all Members Accountable For Their Actions - Without Accountability There Is No Credibility
Have you ever been arrested or charged with a crime within the past twelve months? [ ] Yes [ ] No -If yes please explain on the back of the application. We are very understanding, many of us have been broken and have had our own problems. That is why most of us know what it means to say we walk the walk!
No Application for renewal will be processed without all required information being completed. Make sure you read this carefully before signing. No application for renewal of membership, license or endorsement will be considered or processed without this application being completed in full, signed and dated.
Note: Member's
who make a pledge of $25.00 a month for the stability and advancement of Chaplain
Fellowship Ministries and keep their commitment
will have their membership automatically renewed each year. Member's
records are checked and verified at time renewal request
is received.
Lay Chaplain membership renewal: For the initial donation of $60.00 to cover document production mailing cost and recording of all documents Lay Chaplains will be renewed. Send your renewal and donation to the address listed below.
1. This year I am making a monthly financial commitment of at least ____ $10.00 ____ $15.00 ___ $25.00 ___ $45.00 ___ $65.00 ___ $75.00 ___ $100.00 ___ $200.00 ___ $300.00 ___ $400.00 ___ $500.00 for the stability and future advancement of Chaplain Fellowship Ministries.
2. I can not make a monthly commitment for the stability and advancement of Chaplain Fellowship Ministries. I am making a one time donation of _____ $10.00 ____ $15.00 ___ $25.00 ___ $45.00 ___ $55.00 ___ $65.00 ___ $75.00 ___ $100.00 ___ $200.00 ___ $300.00 ___ $400.00 ___ $500.00 for the stability and advancement of Chaplain Fellowship Ministries.
I hereby certify that the above information is true to the best of my knowledge. I understand that Chaplain Fellowship Ministries will be relying upon this information to grant me approval regarding my membership renewal. I acknowledge that any false information provided by me will be just cause to deny membership renewal. Should any of my responses to these statements change I will immediately notify the home office of Chaplain Fellowship Ministries.
Signature Required: __________________________________________ Date: ________________
Renewal Donation Options! Please read options and instructions carefully!
1. Checks or Money Orders: All donations must be in US funds. Make payable to: Chaplain Fellowship Ministries, Mail your completed renewal application with your check or money order to the address listed below. Renewal membership packages may take up to 2 to 3 weeks for delivery once received in our office.
2. Major credit cards are accepted: You can make your donation using your major credit card by clicking on the add to cart button below. Mail your completed application to the address at the top of this application after making your donation. Renewal membership packages may take up to 2 to 3 weeks for delivery once received in our office.
Chaplain
Fellowship Ministries
7803 Redbrush
Temple, TX 76502-5519
God bless you, and Thank You! Click here to return to the options page!
This section is for office use only!
Date Renewal Form was received : _________________
Approved on:___________________________________
Disapproved on: ________________________________
Member's ID No: _______________________________
Comments or Recommendation:
Please Note: Unscriptural conduct or failure to maintain membership requirements in good standing or doctrinal departure from the tenets of faith shall be considered sufficient Grounds upon which any person may be disqualified and removed from membership. The requirements and information required within this application shall be subject to change without notice. The board of directors does hereby have the right to refuse membership renewal for Unscriptural conduct or failure to maintain membership requirements in good standing. All decisions made by the board of directors are final and binding. No goods or services were provided for donations other than intangible religious benefits.