EPC CHAPLAINCY APPLICATION 

Thank you for your interest in serving as an EPC Volunteer Chaplain. The Chaplain Endorser and Chaplains Works and Care Committee (CWCC) look forward to working with you.

Please fill out the application form below as completely as possible. If you have no response, mark it with a dash; if it doesn’t apply, put n/a.   For questions or concerns, contact Mark Ingles, EPC Chaplain Endorser, at

or 719-433-2747, or Bruce Alexander at

or 571-330-8177.

CIVILIAN VOLUNTEER CHAPLAIN

Step 1 of 2 - Personal Information

  • MM slash DD slash YYYY

  • A. PERSONAL INFORMATION

    Please use a dash (-) for any fields that are not applicable.
  • MM slash DD slash YYYY
  • (If not applicable, leave blank)
    MM slash DD slash YYYY

  • B. FAMILY INFORMATION

    Please use a dash (-) for any fields that are not applicable.

  • C. EDUCATION INFORMATION

    Please use a dash (-) for any fields that are not applicable.
  • Enter mm/yyyy to mm/yyyy
  • Enter mm/yyyy to mm/yyyy
  • Enter mm/yyyy to mm/yyyy

  • D. MINISTRY INFORMATION

    Please use a dash (-) for any fields that are not applicable.
  • Enter mm/yyyy
  • Choose "N/A" if not applicable
  • Enter mm/yyyy
  • Enter mm/yyyy
  • Choose "N/A" if not applicable

  • E. OCCUPATION INFORMATION

    Please use a dash (-) for any fields that are not applicable.

  • F. OTHER INFORMATION

    1. At the end of this form you will attach a Personal Reflection Paper (total: one page) briefly describing your testimony, call to chaplaincy, daily devotional time, and how you would describe yourself. Acceptable file formats: .doc, .docx, .pdf

    2. At the end of this form you will attach a recent photo of yourself. Acceptable file formats: .jpg, .gif, .png, .pdf

    3. Two CWCC-issued written references will be required. Reference forms will be sent to you after we receive your completed application packet. One reference must be from a Teaching Elder or a Ruling Elder.

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