Chaplain Credential Assessment Form

Education Assessment

PORTFOLIO: Official transcripts are required with school seal and registrar’s signature.
High School
City & State
Date Completed

MonthDayYear
COLLEGE/UNIVERSITY NAME:
City & State
ATTENDANCE (MONTH-YEAR):
MAJOR:
DEGREE:
NO. OF CREDITS:
PORTFOLIO: Official transcripts are required with school seal and registrar’s signature.
TECHNICAL/TRADE/MILITARY VOCATIONAL SCHOOL NAME:
ATTENDANCE (MONTH-YEAR):
MAJOR:
INSTRUCTIONAL CONTACT HOURS:

EDUCATION (Continued)

CHAPLAIN/MINISTERIAL HISTORY:

Start with the first assignment and progress in chronological order.
1. ASSIGNMENT NAME:
DESCRIPTION:
PERIOD: From

DayMonthYear
Date
To

DayMonthYear
Date
NUMBER OF MONTHS:
2. ASSIGNMENT NAME:
DESCRIPTION:
PERIOD: From

DayMonthYear
Date
To

DayMonthYear
Date
NUMBER OF MONTHS:
3. ASSIGNMENT NAME:
DESCRIPTION:
PERIOD: From

DayMonthYear
Date
To

DayMonthYear
Date
NUMBER OF MONTHS:

CHAPLAIN/MINISTERIAL HISTORY: ( Continued)
4. EMPLOYER NAME:
EMPLOYMENT PERIOD: From

DayMonthYear
Date
To

DayMonthYear
Date
NUMBER OF MONTHS:
5. ASSIGNMENT NAME:
Discription
EMPLOYMENT PERIOD: From

DayMonthYear
Date
To

DayMonthYear
Date
NUMBER OF MONTHS:
6. ASSIGNMENT NAME:
Discription
EMPLOYMENT PERIOD: From

DayMonthYear
Date
To

DayMonthYear
Date
NUMBER OF MONTHS:
PORTFOLIO: Letters from Employers, Supervisors, or Peers are expected from most recent positions.

Please send copies of Transcripts/Credentials to AAHEA. www.aahea.org
Signature

Application fee

Assessment & Testing

$250.00 Quantity

Chaplaincy Program

Complete purchase of the Full Chaplaincy Program.

$750.00 Quantity

Total

Note: No chaplain candidate will be approved for chaplain status until the full program fee of $750 has been paid.
Should be Empty:

International Circle of Faith Chaplaincy