Two Day RMPFC Advanced Chaplain Training - November 2026
Nov 13-14, 8am - 5pm | Please fill out this form and click submit.
Name
*
Email
*
This address will receive a confirmation email
Phone
*
Address
*
--
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Dietary Restrictions / Food Allergy for Meals
Agency
*
RMPFC Agency Membership List
RMPFC Membership Number
Location Choice
*
Please select one option.
In Person
Online
Course Selection for Nov 14 (Pick Two)
*
Please select all that apply.
ACT 401 1st Aid, CPR, AED, and Stop the Bleed (Not available for online)
ACT 406 Chaplain Safety and De-Escalation
ACT 501 Advanced Moral Injury
ACT 506 Advanced Suicide Prevention
Click here for the RMPFC refund policy.
Refund Policy
*
Please select all that apply.
I agree to the refund policy
Payment
Nov 13 Only RMPFC Member ($50)
Nov 13 Only Non Member ($75)
Nov 14 Only RMPFC Member ($50)
Nov 14 Only Non Member ($75)
Two Day RMPFC Member ($100)
Two Day Non Member ($150)
Nov 13 Only RMPFC Member ($50)
Nov 13 Only Non Member ($75)
Nov 14 Only RMPFC Member ($50)
Nov 14 Only Non Member ($75)
Two Day RMPFC Member ($100)
Two Day Non Member ($150)
Amount
Credit/Debit Card Number
Expiration Date/CVC
Name on Card
Card Billing Address
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Submit
Description
Nov 13-14, 8am - 5pm
Please fill out this form and click submit.
×
Please Fix the Following