Senior Chaplain Membership Upgrade Form

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. Applications cannot be sent by fax or email.

Name: ____________________________________________________ Date: ________________

Address: ________________________________________________________________________

City: ____________________________ State: _______________ Zip Code:__________________

Home Phone (____) _______________________ Business Phone (___)_____________________

E-mail Address: __________________________________________________________________

Hair Color: ____________ Eye Color: __________ Height: __________ Weight: ______________

I have been a member Since: Date: __________________________________________________

My CFM ID Card Number is: _______________________________________________________

My membership expires or expired on: _______________________________________________

In Case of an emergency notify: ____________________________________________________

Relationship _______________________________ Phone: ______________________________

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

No Application for renewal will be processed without all required information being completed. Make sure you read this carefully before signing. No application for renewal of membership, license or endorsement will be considered or processed without this application being completed in full, signed and dated.

Please read carefully: I am requesting my membership be upgraded to senior chaplain membership. My donation of __________$75.00 to cover document production, mailing cost and recording of all documents is enclosed. 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 responsibility. The leadership and dedicated members of Chaplain Fellowship Ministries believe in honesty, integrity and accountability. For this reason Chaplain Fellowship Ministries has adopted a zero tolerance policy regarding senior chaplains who make commitments of support and do not keep their commitment. Such behavior will be considered unscriptural conduct and failure to maintain membership requirements in good standing.

Note: Members who make a firm commitment of financial support of at least $25.00 a month for the stability and advancement of Chaplain Fellowship Ministries and keep their commitment will have their membership automatically renewed each year. Even though it is not required all members of Chaplain Fellowship Ministries should consider recruit new members.

1. This year I am making a monthly financial commitment of at least $20.00 ___ $25.00 ____ $45.00 ____ $65.00 ____ $75.00 ____ $100.00 ___ $200.00 ___ $300.00 ___ $400.00 ___ $500.00 ____ for the stability and advancement of Chaplain Fellowship Ministries.

I understand that Senior Chaplains who fail to keep their monthly commitment will be removed from the membership rolls for unscriptural conduct and failure to maintain membership requirements in good standing. Furthermore they will not be allowed to renew their memberships without prior approval from the home office.

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 will be relying upon this information to grant me approval regarding my membership renewal. I acknowledge that any false information provided by me will be just cause to deny renewal of my membership. Should any of my responses to these statements change I will immediately notify the home office of Chaplain Fellowship Ministries.

Signature Is Required: __________________________________________ Date: _____________

1. Checks or Money Orders: All donations must be in US funds. Make payable to: Chaplain Fellowship Ministries, Mail your Senior Chaplain upgrade application with your check or money order to the address listed below. Personal checks will have to clear the bank before documents will be sent out.

2. Major credit cards are accepted: You can make your donation using your major credit card by clicking on the add to cart button below. Mail your completed application to the address listed below after you make your donation. Upgrade membership packages may take up to 2 to 3 weeks for delivery once received in our office.

Please Note: Unscriptural conduct or 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 from membership. The requirements and information required within this application shall be subject to change without notice. The board of directors does hereby have the right to refuse membership renewal for Unscriptural conduct or failure to maintain membership requirements in good standing. All decisions made by the board of directors has be final and binding. No goods or services were provided for this donation other than intangible religious benefits.