Members Requesting Updated Ecclesiastical Endorsement

Members Requesting Updated Ecclesiastical Endorsement
- If you are requesting an updated ecclesiastical endorsement, complete the form below.
- You must be a member in good standing before we can process your updated endorsement.
- * - Indicates required field.
Full Name*

RankFirst NameMiddle NameLast NameSuffix
Birthdate*

MonthDayYear
Date
Current Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Residential Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Does your mailing address differ from your residential?*

YesNo
Current Phone Number*
Current Email*

Confirmation Email
If any of the above information has changed, check the box:

RankAddressPhoneE-mail
Number of years of professional ministry experience:*
Total number of months served on either Title 10 or Title 32 active duty orders for prior and current military service, including training. The numbers must be listed as months only, which is required on the endorsement form.
Officer (Active Duty months only)*
Enlisted (Active Duty months only)*
The above needs to be completed accurately as this information is required on your updated endorsement. Do not put in the number of years.
Choose one of the following.*

Army Active DutyNavy Active DutyAir Force Active DutyArmy ReserveNavy ReserveAir Force ReserveArmy National GuardAir National GuardCivil Air PatrolArmy Reserve (AGR)
Click the “Submit” button below to submit this request. In so doing, if there were no problems, the message "Thank you for submitting your Armed Forces Military Members Requesting Updated Endorsement!" will appear in this space, and you will also receive an e-mail copy of your request. You may also print a copy of your request by clicking on the "Print Form" button below. Clicking the "Print Form" button DOES NOT SUBMIT YOUR REQUEST.
Should be Empty: