Application for Ecclesiastical Endorsement/Appointment As Chaplain, Seminarian

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PERSONAL DATA

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xx/xx/xxxx
Phone Numbers
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Home Address


Work Address


PERSONAL DATA (cont.)











FAMILY AND MARITAL DATA

5=strongly interested, 1=not very interested


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Last Name First Name Middle Initial DOB
Child Info:
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EMERGENCY CONTACT

Someone other than yourself, who will always know your whereabouts.

Address


MINISTERIAL & SPIRITUAL DATA

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Date By Phone:
Licensed:
Ordained:

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Previously Applied For Endorsement
MINISTERIAL EXPERIENCE

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EDUCATIONAL DATA

Request transcripts be sent to:

Chaplaincy of Grace Churches International
5117 Cliffdale Road
Fayetteville, NC 28314 

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SECULAR OCCUPATIONAL DATA

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MILITARY DATA








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REFERENCES

General References (as indicated below, other than relatives). In order for us to obtain meaningful information from those who know you well enough to evaluate your ministry talents, list at least one of each category below: 

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PRESENT PASTOR

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OTHER PASTOR

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COLLEGE

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SEMINARY

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OTHER

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STATEMENT OF RECORD

This form must be completed by all who apply for or hold Ecclesiastical Endorsement or Recognition From The Chaplaincy Of Grace Churches International. 

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No application for ecclesiastical endorsement, recognition, or re-endorsement will be processed without this signed and dated document.

By my signature, I certify that the above is true and accurate. I understand that falsification of this data in any manner will bring immediate revocation of my endorsement/recognition and/or cessation of the endorsement process. I further understand that if I am ever charged with, accused of, investigated for, moved because of, or transferred to another position because of any sexual misconduct or sexual harassment. that I will immediately (within 72 hours) contact the Chaplaincy of Grace Churches International home office to report the same, and that failure to do so may bring immediate revocation of my endorsement/recognition. 

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COVENANT FOR MILITARY CHAPLAINS

Covenant

Having accepted God's Call to minister to the people who serve in the Armed Forces of our country, I covenant with God to serve Him and these people with His help; to deepen my obedience to the commandments; to love the Lord our God with all my heart, soul, mind and strength, and to love my neighbor as myself. In affirmation of this commitment, I will abide by the Code of Ethics of the Chaplains of the Armed Forces, and I will faithfully support its purposes and ideals. As further affirmation of my commitment, I covenant with my colleagues in ministry that we will hold one another accountable for fulfillment of all public actions set forth in our Code of Ethics.

Code of Ethics

  • I will hold in trust the traditions and practices of my religious body.
  • I will carefully adhere to whatever direction may be conveyed to me by my endorsing body for maintenance of my endorsement.
  • I understand as a chaplain in the Armed Forces that I must function in a pluralistic environment with chaplains of other religious bodies to provide for ministry to all military personnel and their families entrusted to my care.
  • I will, if in a supervisory position, respect the practices and beliefs of each chaplain I supervise, and exercise care not to require of them any service or practice that would be in violation of the faith practices of their particular religious body.
  • I will seek to provide for pastoral care and ministry to persons of religious bodies other than my own within my area of responsibility with the same investment, of myself as I give to members of my own religious body. I will work collegially with chaplains of religious bodies other than my own as together we seek to provide full ministry to our people as much as possible. I will respect the beliefs and traditions of my colleagues and those to whom I minister. When conducting services of worship that include persons of other than my religious body, I will draw upon those beliefs, principles and practices that we have in common.
  • I will seek to support all colleagues in ministry by building constructive relationships wherever I serve, both with the staff where I work and with colleagues throughout the military environment.
  • I will maintain a disciplined ministry in such ways as keeping hours of prayers and devotion, endeavoring to maintain wholesome family relationships, and regularly engaging in educational and recreational activities for professional and personal development. 
  • I will seek to maintain good health habits.
  • I will recognize that my obligation is to provide ministry to all members of the Military Services, their families, and other authorized personnel. I will only accept added responsibility in civilian ministry if it does not interfere with the overall effectiveness of my primary military ministry.
  • I will defend my colleagues against unfair discrimination on the basis of gender, race. religion or national origin.
  • I will hold in confidence any privileged communication received by me during the conduct of my ministry. I will not disclose confidential communications in private or in public.
  • I will not proselytize from other religious bodies, but I retain the right to evangelize those who are non-affiliated.
  • I will show personal love for God in my life and ministry, as I strive together with my colleagues to preserve the dignity, maintain the discipline and promote the integrity of the profession to which we have been called. 

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STATEMENT OF FINANCIAL COMMITMENT COVENANT

Chaplaincy of Grace Churches International (GCI) is a faith ministry. We do not charge for our services. In order for Chaplaincy of Grace Churches International to cover administrative and travel expenses, it is imperative that all our chaplains support the home office with prayer and financial donations, as the LORD leads you. We encourage chaplains to give 4% of their tithe to the GCI Chaplains Fund.  Contributions can be made to:  GCI Chaplains, 5117 Cliffdale Road, Fayetteville, NC 28314.  Please contact our endorser if you have any questions. Let us covenant to support each other!

I am in agreement with this Statement of Financial Commitment Covenant. 

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STATEMENT OF AUTHORIZATION

This form must be completed by all who apply for or hold Ecclesiastical Endorsement or Recognition From The Chaplaincy Of Grace Churches International. 

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Address


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Please list all the addresses (including street, city, state, and zip) and time-frames where you have resided for any period greater than thirty days for the past fifteen years.

Previous Addresses

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No application for ecclesiastical endorsement, recognition, or re-endorsement will be processed without this signed and dated document. By my signature, I authorize the Chaplaincy of Grace Churches International and their designated investigating agency to conduct a criminal background check on me. I understand that any negative report may result in the cessation of the endorsement process. I further understand and agree that if I am ever charged with, accused of, investigated for, moved because of, or transferred to another position because of alleged criminal and/or sexual misconduct that this document authorizes my employer or volunteer chaplaincy organization to release this information to the Chaplaincy of Grace Churches International. 

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**** Please be prepared to pay a $100 fee (via Paypal) to help defray the costs of the criminal background investigation. ***   

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