NAVAL CHAPLAIN PASTORAL CORPS

___AUXILIARY SQUADRON________________________CHAPLAIN RANK

MEMBERSHIP APPLICATION
( ) New Chaplain ( ) Old Member Chaplain _________Current
C/Rank ______ http://navalchaplaincorps.weebly.com/
SECTION I – PERSONAL DATA OF APPLICANT
LAST NAME FIRST NAME MIDDLE NAME GENDER SUFFIX
(√ ) Male
( ) Female
NAME OF CHURCH AND ADDRESS INDICATE IF YOU ARE THE PASTOR OR OTHER POSITION:

HOME ADDRESS

MARITAL STATUS NAME OF SPOUSE NO. OF CHILDREN

( ) Single ( √) Married ( ) Separated
( ) Widow/Widower
HEIGHT WEIGHT COLOR OF EYES COLOR OF HAIR

IF A MILITARY/PNP PLS INDICATE THE ORGANIZATION AND RANK (YEAR OF

ENLISTMENT/COMMISION

SSS/GSIS NO. DATE OF BIRTH PLACE OF BIRTH

CITIZENSHIP RELIGION BLOOD TYPE

Filipino

TEL. NO. (HOME) TEL. NO. (BUSINESS) MOBILE PHONE

EMAIL 1 EMAIL 2 FAX NO.

ACR NO. (IF ALIEN) PASSPORT TYPE OF VISA ISSUED TIN NO.
NO./EXPIRY DATE

SECTION II – EDUCATIONAL BACKGROUND – College/Post-Grad/Special Studies

NAME OF SCHOOL DEGREES INCLUSIVE YEAR GRADUATED
OBTAINED DATES

(Attach photocopies of either the transcript of records, diploma or PRC certificate)

SECTION III – CAREER EMPLOYMENT OR CHURCH MINISTRY BACKGROUND
(/ ) EMPLOYED ( ) OWN BUSINESS
COMPANY/CHURCH NATURE OF DESIGNATION INCLUSIVE DATES
BUSINESS

(Used Another Sheet of Paper if Space is not Enough)

FOR PAST OR CURRENTLY IN GOVERNMENT POSITION – Please state highest Appointed/Elected
Office
Position/Period Assumed:
PROFESSIONAL LICENSES:
(Attach certification from the Office concerned)
SECTION IV – SIGNATURE/ 1X1 PHOTO

____________________
1X1 photo Signature over Printed Name

FB Account: Naval Chaplain Pastoral Corps