NOTE: Only Florida Baptist chaplans may apply for certification.

Name: Address: Email:

City: State: Zip Code:

Phone: Cell Phone:

Employment:

Church Membership:

Are you serving as a volunteer chaplain now? Where?

How long? Years Months

Has the facility designated you as their chaplain?

Have you completed the Basic Volunteer Chaplain Application? If not, please complete it now.

Go to Basic Application.

Required Training(20 Hours)

Please list classes, seminars, conferences, special courses, etc., indicating the dates and credit hours you received.

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5.

References

Please complete the following :

Letter of recommendation from your pastor

Letter from supervisor validating 6 months service as a chaplain volunteer

 

CHAPLAIN'S COMMITMENT

I understand that the Volunteer Chaplain receives approval from the Chaplaincy Ministry of the Florida Baptist Convention. I will support the policies and guidelines as set forth by the State Director of Chaplaincy Ministry.

I understand that the State Director of Chaplaincy Ministries may withdraw their approval should I prove by temperment, disposition, attitude, conduct or otherwise to misrepresent the position of Volunteer Chaplain. I agree to abide by the State Director of Chaplaincy decisions related to my FBC approval as a Volunteer Chaplain.

My Response

Signed: Date:

Note: Please forward a digital picture with your application to mjohnston@flbaptist.org