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.

Name: ___________________________________________ Date: ______________________

Address: ____________________________________________________________________

City: _______________________________ State: ___________Zip Code: _______________

Home Phone (____) _____________________Business Phone (___)____________________

E-mail Address: _______________________________________________________________

Date of Birth: ________________________ Age: _____________ Sex: __________________

Marital Status: [ ] Single [ ] Married [ ] Divorced [ ] Remarried [ ] Other

Hair Color: __________ Eye Color: ____________Height: _________Weight: ____________

Current Driver License or State ID #: __________________________State: _____________

Veteran: [ ] Yes [ ] No - Your Present Occupation: _________________________________

Are you credentialed for ministry? [ ] Yes [ ] Licensed [ ] Ordained [ ] NO

If so, what Church or Denomination? ____________________________________________

How did you find out about us? ________________________________________________

Who recommended CFMI to you: ______________________________________________

Choose your area of ministry from the following: [ ] Police [ ] Fire [ ] EMS

[ ] Military [ ] Corporate [ ] Victims [ ] Chemical Dependency [ ] School [ ] Hospice

[ ] Critical Incident [ ] Crisis Intervention [ ] Jail [ ] Prison Ministry [ ] Street Ministry

[ ] Hospital [ ] Nursing Home [ ] Other___________________________________________

Have you ever been convicted of a felony? [ ] Yes [ ] No -If yes please explain on the back of the application. This does not mean you will not be approved! 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!

---

(All required documents must be included with your application)

Make sure you read this application very carefully before signing, there are four different options offered. No application will be considered or processed without this application being completed in full, signed; dated and all required documents must be included. All memberships and ID cards must be renewed each year on or before the renewal date located on your membership certificate and ID Card. Please be sure to provide the following with your application. No application will be processed unless the following requirements are complete:

1. Resume – A resume of sort, detailing what you would like to do to help those who are in pain or suffering.
2. Documents and ministerial experience – Include any documents and ministerial experience you have, if you have none, Please tell us anything you feel that would help us understand your need to become a member or to be endorsed by Chaplain Fellowship Ministries. We are recruiting people that know how to walk the walk, so we are very understanding to your calling. We are looking for those who know how to give from the heart for the Glory of God, Not man.
3. Passport Photo, NOT A COPY OF YOUR PASSPORT– One passport photo, nothing else will be accepted. The quality of your ID card will depend on the quality of the photo you submit with your application.
4. Letters of Reference – Two letters of reference from someone that knows you and your efforts to help the suffering & needy.
5. Photocopy of Current driver’s license or State ID Card – Identification must be verified, forward with your application a photocopy of your Current driver's license or State ID card. The quality of your ID Card will depend on the quality of the photo you submit.

Please Note: Any member who make a firm financial commitment of at least $25.00 a month for the stability and advancement of Chaplain Fellowship Ministries, and keeps their commitment, will have their membership automatically renewed each year.

---

Option 4 check here: ______ I am requesting certification as a Senior Chaplain. Your initial donation of $185.00 covers document production, mailing cost, recording fees and ministry items listed below. Senior Chaplains are required to make a firm monthly commitment of financial support for the stability and future advancement of the ministry, thereby acknowledging that no institution can stand or be of full service unless all members accept the responsibility of maintaining their monthly commitment of financial support. Members who fail to keep their monthly commitment will be reduced to Basic Chaplain Status.

1. Certificate of Appointment as a Senior Chaplain
2. Certificate of Membership with official seal & ribbons
3. Certificate of Endorsement with official seal & ribbons
4. Certificate of Title as a chaplain with official seal & ribbons
5. Certificate of Ordination with official seal & ribbons
6. Certificate of License with official seal & ribbons
7. Letter of recommendation with official ministry seal
8. Letter of good standing with official ministry seal
9. Certified Senior Chaplains Photo ID card
10. Two CFMI Members Shoulder Patches
11. One CFMI Lapel Pin for shirt or coat
12. One CFMI clergy emergency dashboard card
13.One CFMI chaplain windshield decal

14. My donation of ______ $185.00 is enclosed to covers document production, mailing cost, recording fees and ministry items listed above.

15. This year I am making a monthly commitment of at least ____$15.00 ___$25.00 ____$45.00 ____$65.00 ____$75.00 ____$100.00 __________Or More for the stability and future advancement of Chaplain Fellowship Ministries.

---

1. Unscriptural conduct, 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 as a member. Such discipline shall be prayerfully administered according to Scriptures by the Governing Board of Directors (Matt. 18:15-17; Rom. 16:17; 1 Cor. 5:9-13; 2 Thess. 3:6). I understand that if I am ever charged with, accused of, investigated for, moved or removed because of, or transferred to another position because of alleged criminal and/or sexual and/or ethical misconduct that this document authorizes my employer or volunteer chaplaincy organization to release all information to Chaplain Fellowship Ministries or their designated investigating agency.

2. I fully understand that I am responsible for my own actions as an Ordained Chaplain, Minister, Priest or Pastor. I further understand that Chaplain Fellowship Ministries International Inc. and all board members, directors, associate Churches, Ministries, Ministers, Priests, Pastors and Chaplains shall not be held liable for any damages caused by the misuse or misrepresent of my credentials, ministry license, title, position, qualifications, education or experience.

 

Signature Is Required: _______________________________________ Date: _____________

---

Personal information is not published, sold or given to outsiders: All personal information given is strictly confidential; it is only used for confirmation of your endorsement and certification which is logged in our legally licensed membership ledger and recorded for duly authorized ministry verification purposes only. Any alterations to this form will cause it to be void and application will not be considered. In such case the application will be returned to the applicant along with any donations made for consideration for membership. In the event that an applicant is not approved, the applicants donation will be returned to them in full.

---

Donation Options! Please read options and instructions carefully!

1. Checks or Money Orders: All funds must be in US funds. Make payable to: Chaplain Fellowship Ministries, Mail your completed application with your check or money order to the address listed below. Please Note: New 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 membership donation using your major credit card by click on donation button below. Mail your completed application to the address listed below after making your donation. Please Note: New 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

Attn: Documents

God bless you, and Thank You! Click here to return to the options page!

---

For office use only

Date Application was received: _________________

Date Application was reviewed: _________________

Date vote was taken: _________________________

Approved on: _______________________________

Disapproved on: ____________________________

CFM File No: ______________________________

Signatures of Senior Staff Members reviewing application.

Chaplain: ______________________________________

Chaplain: ______________________________________

Chaplain: ______________________________________

Chaplain Fellowship Ministries is a faith based Christian Public Charity legally incorporated as a Nonprofit Corporation with Chaplains, Pastors, Priest and Ministers working worldwide. The requirements and information required within this application shall be subject to change without notice. Chaplain Fellowship Ministries reserves the right to refuse membership, membership renewal, ordination, license or endorsement by directive of the board of directors of Chaplain Fellowship Ministries. All decisions made by the board of directors shall be binding and final. No goods or services were provided for this donation other than intangible religious benefits.