Global Chaplaincy Center Application

Global Chaplaincy Center Application
Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address
example@example.com
Best Contact Number
Marital Status

SingleMarriedWidowDivorcedOther
Citizenship

CanadianAmericanPermanent ResidentOther
Please share your interest in becoming a Chaplain.
Spouse's Full Name (If Applicable):
Do they support your Chaplain Application?

YesNoUnsure
Have you ever been convicted of a crime? If yes, please explain.
Are you willing and able to apply for and submit a comprehensive Police Record as part of the application process?

YesNo
MINISTRY GIFTINGS

According to the Seven Mountain Mandate, which specific area(s) do you believe God has equipped you to serve in as a Chaplain?
EducationReligionFamilyBusinessGovernment/MilitaryArts/EntertainmentMedia
INDIVIDUAL PROFILE
What are your strengths?
What are your opportunities for growth?
Share with us the passion and purpose behind you applying to become a Chaplain and describe any previous Chaplaincy experience.
EMPLOYMENT INFORMATION
Occupation

Company Name

Telephone NumberHow many years

Supervisor's Name
Previous Occupation

Company Name

How many yearsHow many years

Supervisor's Name
CHURCH INFORMATION
Current Church

Name of Pastor

How many years?Pastor's Email Address

Church Address
In which Ministries do you currently serve?
DECLARATION
I affirm before God and the officers of the Global Chaplaincy Center, that the information provided in this application form is true and accurate to the best of my knowledge. I accept and understand that in the case that any of this information supplied turns out to be false or misleading, that it will constitute a reason for denial and/or termination of both my ministry and affiliation with the Global Chaplaincy Center.

I also accept and acknowledge that the credentials and indentification badge provided to me by acceptance and meet the year to year qualifications to remain in good standing.
Signature

Clear
Printed Name
Please upload your background check.

Cancelof
REFERENCES

To complete your reference checks, please provide the contact information for your Pastor and the names of to two non-family members. By providing this information, I confirm permission to contact my pastor and the references provided.
Pastor

Pastor's Name

Pastor's Email Address

Email AddressTelephone Number

Postal / Zip Code
Non-Family Member #1

Name

Email Address

Email AddressTelephone Number

Postal / Zip Code
Non-Family Member #2

Name

Email Address

Email AddressTelephone Number

Postal / Zip Code
My Products*
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Global Chaplaincy Center Application FeeGlobal Chaplaincy Center Application Fee
$1,000.00

Total

$0.00
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Global Chaplaincy Center Application

MINISTRY GIFTINGS

INDIVIDUAL PROFILE

EMPLOYMENT INFORMATION

CHURCH INFORMATION

DECLARATION