Date:
Full Name
Nickname
Social Security Number
Date of Birth
This is to request an ecclesiastical endorsement for a Chaplaincy in (check one):
US Air Force Reserve
Air National Guard
US Army Reserve
Army National Guard
US Navy Reserve
Civil Air Patrol
Federal Bureau of Prisons
Veterans Affairs Medical Center
Chaplain Candidate Program (Seminarian) Branch
Military Chaplains
Are you seeking immediate
Yes
VA/FBP Chaplains
Are you seeking:
Full-time appointment
Part-time appointment
Intermittent appointment
Contract appointment?
CAP Chaplains
Have you been guaranteed an assignment?
All Chaplains
Have you filed a Military/Federal Application?
1. PREVIOUS MILITARY SERVICE:
a. Branch, date, rank or rate, indicate periods of active duty
b. Present status
2. CURRENT ADDRESSES Home Address
Street
City
State
Zipcode
Home phone
(including area code)
Email
Work Address
Street
City
State
Zipcode
Office phone
(including area code)
Office Email
3. FAMILY INFORMATION
Do you or any family members have special health or educational needs?
No Yes
If yes, explain:
All three federal chaplaincies (US Military, Veterans Affairs, Fed Bureau of Prisons) expect us to endorse priests who can pass a stringent medical exam and maintain a healthy life style. Therefore we require that you respond to these two health questions in this application:
What do you currently do on a regular basis to maintain good health?
Do you have any health history or current health matter (including weight) which could possibly be a reason for you to fail the respective federal agency's physical?
4. EDUCATION
5. ORDINATION
Deacon
Priest
If you are not ordained by the Episcopal Church, in what stage of the ordination process are you?
- Date
- Date
- Date
6. NAME AND DIOCESE OF YOUR CURRENT CANONICAL BISHOP
Name of Bishop
Diocese
Before you submit this application you must have a face-to-face conversation with your diocesan bishop notifying him/her of your desire to be endorsed by this office. Date of conversation
7. PASTORAL EXPERIENCE
8. PRESENT POSITION (if not listed above):
9. Are you willing to facilitate ministry to members of all faith groups?
10. ENCLOSURES AND REQUESTS
a. SPIRITUAL JOURNEY PAPER instructions: Send to Bp. Packard by email gpackard@episcopalchurch.org (or postal service mail if you do not use email) a “Spiritual Journey” paper. This paper must be a minimum of four pages but not more than six pages, double-spaced.
The paper must include --but not be limited to --the following three areas:
Share the key events, persons (lay and/or ordained), specific congregations, personal experiences/circumstances God has used to lead you toward Holy Orders as a priest in his Church. Share the specific forms and places of service your ministry has involved prior to and since your call. Include at least one-half a page at the end of your paper in which you share the events, circumstances, persons, etc. God has used to draw you to apply for the specific kind of chaplain ministry for which you hope to be endorsed -- i.e. VA chaplaincy, Federal Prisons chaplaincy or military chaplaincy.
b. List the names and addresses of three clergy and two laypersons to whom the Bishop for Chaplaincies may write for letters of recommendation. Please do not list your Diocesan Bishop as a clerical reference.
Clergy
c. Send a photograph (approx. 2 1/2 x 3 1/2) taken within the last six months
You may send the photo electronically to aleveque@episcopalchurch.org or send it by snail mail to:
d. Request transcripts from your Colleges and Seminary to be sent directly from the schools to the Office of the Bishop for Federal Ministries Have transcripts sent to:
e. Send a current CDO Personal Profile (exception: Chaplain Candidate [Seminarian] Program Send the CDO Personal Profile to:
Statement of Understanding: a. I understand that I may be interviewed by a Committee representing the Bishop for Chaplaincies.
b. I understand that if I am commissioned in the Reserves of the US Army, US Navy, or the US Air Force, I am subject to being ordered to active duty at any time during a national emergency or general mobilization.
c. I understand that as a Chaplain in this ministry, I will be required to submit reports of ministry in a timely fashion, as directed by the Bishop for Federal Ministries, and to forward within thirty days the records of all my pastoral acts performed on Federal property, to the Bishop for Federal Ministries for proper recording by the Office of the Bishop for Federal Ministries.
d. I understand that as a Chaplain in this ministry, I will be expected to attend one of the Chaplain's Conferences annually, unless excused by the Bishop for Federal Ministries.
e. Since this application is the basis for initial, subsequent, and continuing endorsement, I understand that I am expected to keep Office of the Bishop for Federal Ministries informed of any changes in my status or whereabouts.
f. I recognize the authority of the Bishop for Federal Ministries to grant or withdraw ecclesiastical endorsement for the Episcopal Church in the USA rests solely with the Bishop
