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? [     ] NO [     ] Yes [     ] Licensed [     ] Ordained [     ] Commissioned

If yes? Who with: ___________________________________________________________________

Did a member recommend you: Yes ___________ No: ___________

If yes? Member's Name: _____________________________________________________________

Member's ID#: ____________________________________________________________________

In Case of an emergency notify: _______________________________________________________

Relationship _________________________________ Phone: ______________________________

PLEASE READ EVERYTHING ON THIS APPLICATION CAREFULLY

Document Quality and Security: All documents are produced by commercial laser jet printers for the highest quality. We use parchment paper for all our documents, not card stock, or redesigned certificates. Our ID Cards are 30 mill PVC "Plastic" cards with holograph seals of authenticity, security bar codes, and an overlay to protect your card. ID cards are produced with commercial ID equipment owned by CFMI which protects your personal information from identity theft . Your personal information is kept in locked file cabinets at all times. It never leaves our office for any reason. We do not trade, share, lease or sell our member's personal information to anyone for any reason.

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Criminal Background: Have you been convicted of a felony? [    ] Yes [    ] No - If yes please explain on a separate sheet of paper and include any legal documents detailing your conviction. Chaplain Fellowship does background checks on all applicants. 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!

Senior Chaplain membership Requirements: To be a Senior Chaplain the applicant must have 5 years of experience in an existing field of ministry and provide certificates of completion and certification showing they are qualified in their chosen field of ministry. For example if you are a prison ministry chaplain you would have to have 5 years of experience in prison ministry. In other words you must have 5 years of experience in a specific field of ministry, not just in ministry itself.

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SENIOR CHAPLAIN UPGRADE DONATION FOR PROCESSING MEMBERSHIP IS $75.00. Senior Chaplain membership upgrade include the items listed below. Membership upgrade packages may take up to 3 to 4 weeks for delivery once application has been received and approved. Senior Chaplains are held to a higher standard by the very nature of their positions and are expected to accept responsibility for the stability and advancement of the ministry by making a monthly commitment of support. Thereby acknowledging that no faith based institution or ministry can stand or be of full service unless all members accept some responsibility for the welfare of the ministry.

1. Ministry Membership Certificate
2. Ministry Endorsement Certificate
3. Ministry Ordination Certificate
4. Ministry License Certificate
5. Ministry Letter of good standing
6. Chaplain's Photo ID Card with holograph seals of authenticity, security bar code and overlay
7. Ministry Appointment as a Senior Chaplain Certificate

Ministry Partners are Members who make a $25.00 a month pledge of support for the stability and advancement of the ministry. Thereby acknowledging that no faith based institution or ministry can stand or be of full service unless all members accept some responsibility for the welfare of the ministry. Ministry partner's who keep their pledge will have their membership automatically renewed the following year. Ministry Partners also receive discounts on training courses and ministry supplies.

Ministry Partner: I want to be a ministry partner, I am making a monthly pledge of [     ]  $25.00 [     ]  $30.00 [     ]  $35.00 [     ]  $45.00 [     ]  $55.00 [     ] $100.00 [     ]  $200.00 [     ] $300.00 [     ] $400.00  [     ] $500.00 for the stability and advancement of Chaplain Fellowship Ministries.

Your monthly support no matter how small will be a blessing for the stability and advancement of the ministry. Donation help provide memberships and training for those who are less fortunate. Donations also make it possible to reach out to senior citizens, military families and poor families in our communities nationwide with groceries, utility bills, school supplies, medication and rent. Donations also help provide educational grants for members so they can serve in their communities nationwide.

(a) I am making a monthly pledge of: [     ] $10.00 [     ] $15.00 [     ] $20.00 [     ]  $25.00 [     ]  $30.00 [     ]  $35.00 [     ]  $45.00 [     ]  $55.00 [     ] $100.00 [     ]  $200.00 [     ] $300.00 [     ] $400.00  [     ] $500.00 for the stability and advancement of Chaplain Fellowship Ministries.

1. I understand that I will be held accountable for my action. Chaplain Fellowship Ministries and ministry partners have zero tolerance policy regarding members who fail to maintain the terms and conditions of membership in good standing. I acknowledge that should I violate the terms and conditions of my membership as a Senior Chaplain the following hereby applies. Chaplain Fellowship Ministries has an obligation and do hereby reserves the rights to withdraw my membership, endorsement and ordination. I understand that my membership with Chaplain Fellowship Ministries does not give me the rights to state or federal tax exemption. Furthermore I am giving my authorization to Chaplain Fellowship Ministries to run a criminal background. Senior Chaplain who fail to keep their monthly commitment show a lack of responsibility and will have to renew their membership as a registered chaplain! Where there is no accountability, there is no credibility.

 

Signature Is Required: ______________________________________________________ (Required)

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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 the event that an applicant is not approved denied membership, the applicants donation will be returned to them in full. All documents submitted with application for membership become the property of Chaplain Fellowship Ministries.

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Chaplain Fellowship Ministries Holds all Members Accountable For Their Action - Without Accountability There Is No Credibility

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 member may be disqualified and removed as a member of Chaplain Fellowship Ministries. 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). Members agree to the following: If any member is ever charged with a criminal act/sexual misconduct or assault, ethical misconduct "Conduct unbecoming of a chaplain or minister" that this document authorizes their employer or volunteer chaplaincy organization to release all information to Chaplain Fellowship Ministries or their designated investigating agency.

I hereby certify that the above information is true to the best of my knowledge. I understand that Chaplain Fellowship Ministries or affiliate ministries will be relying upon this information to grant me approval regarding ordination, license and endorsement. I acknowledge that any significant and material misstatements made by me will be just cause to deny membership, license, ordination or endorsement. Should any of my responses to these statements change I will immediately notify the home office of Chaplain Fellowship ministries. Every member of Chaplain Fellowship Ministries must agree to commit themselves to the responsibility of living within the established standards of the agreement within this application for membership. When a member fails to meet the responsibilities upon which they have agreed, then there is a need to hold the individual accountable. The purpose for accountability and discipline is to provide an opportunity for understanding, personal growth, and development. We believe that all members should want to help build up the Lords' ministry by recruiting new members, thereby acknowledging that no institution can stand or be of full service unless all members accept some responsibility for the welfare of the ministry. It is our prayer and hope that you as a new member will feel the same and consider helping us in the mission and vision the Lord has given us. "A ministry of His people".

 

Signature Is Required: _________________________________________________ (Required)

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DONATION OPTIONS! PLEASE READ CAREFULLY!

Checks or Money Orders: All donations must be in US funds. Make payable to: Chaplain Fellowship Ministries, Mail your completed application with your check or money order to the address at the top of this page. Checks must clear our bank before documents will be processed. New membership packages may take up to 3 to 4 weeks for delivery once received and approved.

Major Credit Cards: You can make your donation using your major credit card by clicking on the donation button below. There will be a $5.00 charge added to the amount to cover PayPal fees. Mail your completed application to the address at the top of this page after you make your donation. New membership packages may take up to 3 to 4 weeks for delivery once received in our office. Application must be sent in for processing within 30 Days from the date your donation was made through PayPal.

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

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FOR OFFICIAL OFFICE USE ONLY

Date Application was received: _________________

Date Application was reviewed: _________________

Date vote was taken: _________________________

Approved on: _______________________________

Disapproved on: ____________________________

Member's ID No: ______________________________

Staff Members reviewing application.

Dr. ______________________________________

Dr. ______________________________________

Dr. ______________________________________