Board Endorsed Clinical Chaplain, Board Certified Associate Chaplain, Board Certified Pastoral Counselor
Documentation Submission

Please note: New for 2021!

Because of the quantity of applications we now receive for certification, we can no longer take documentation in pieces. Documentation must be complete and uploaded via this form it its entirety.

Documentation that is not complete will be deleted.

First Name *

Last Name *

Email *

Phone Number *

Full Address *

Street Address *

Address Line 2

City *

State / Province *

Zip / Postal Code *

Country *

Did you already fill out the application and pay the application and interview fee? This form and documentation submitted will not be accepted until you have filled out your application.
Yes No

CPE Certificates (may select multiple files) *

College Transcript and Diploma (may select multiple files) *

Endorsement and Ordination documentation (may select multiple files) *

Theology of Chaplaincy essay (1 file) *

Biography and journey of faith (1 file) *

Two verbatim case studies (may select multiple files) *

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