RMPFC Chaplain Application

Thank you for taking the time to apply to be a Chaplain with the Rocky Mountain Police & Fire Chaplains. We appreciate your interest in joining our team. There is a movment of God to reach and support our Emergency Responders and their family. We have seen great impact throughout the Rocky Mountain Region and moving nationally.

We see impacts in helping those that serve us cope in healthy ways with the daily stress that they experience, grow in their relationional health, become more fiancially secure with their eyes focused on the future, and an improvement in their general wellness. We have also seen our responders have spiritual conversations, ask questions about thier experiences of God, begin growing in their personal faith journey, and help others in their faith.

Upon completion of your application, we will contact you regarding the next steps in the chaplain process. I am grateful for the opportunity to consider you for a role within RMPFC and look forward to discussing your qualifications further.

Personal Information

Name

This address will receive a confirmation email

Work Phone

Mobile Phone

Address

Date of Birth (for Background Check)

Current Driver License Number

What Social Media are you on? List Below.

Call to Emergency Responder Chaplaincy

Why do you want to serve as a Chaplain?

What can you add or contribute to a Chaplain Program?

Ministry Affiliation

Organization or Church Name

Faith or Denomination Affiliation

Address

Current Position

Ministry Reference

Ministry Supervisor

Contact Phone

Contact Email

Previous Ministry Positions

Other Relevant Experience

Current Law Enforcement or Fire Reference (if currently working with an agency)

Agency

Agency Supervisor

Contact Phone

Contact Email

Dates Served From to Current

Previous Law Enforcement or Fire Reference

Agency

Agency Supervisor

Contact Phone

Contact Email

Dates Served

Emergency Responder Experience

Previous sworn Emergency Responder (Y/N)

If Yes, what agency?

First Personal Reference (Non-family relationship)

Name

Relationship

How long have you known this person?

Contact Phone

Contact Email

Second Personal Reference (Non-family relationship)

Name

Relationship

How long have you known this person?

Contact Phone

Contact Email

New Chaplain Information

An extensive background check will be completed by a Law Enforcement Agency.

Have you ever been arrested? (Y/N)

If Yes, please explain (Dates, Charges -Felony or Misdemeanor-, Convictions, Restitution, etc.):

Have you ever had your drivers license revoked or suspended? (Y/N)

If Yes, please explain:

Existing Chaplain Information (those serving as a Chaplain for a minimum of three years)

Have you passed a Law Enforcement background screening process with your agency? (If no, this application will be use to run a criminal background check) (Y/N)

Have you received any training pertaining to chaplaincy? (Emergency Responder Chaplain Training, Victim advocacy, crisis response, suicide, behavioral, stress management, PTSD) Please list.

Are you willing to participate in on-going training? and continuing education (Y/N)

Are you willing to attend regular Chaplain meetings, regionally, and RMPFC Annual meeting? (Y/N)

Do you agree to receive an annual review from RMPFC? (Y/N)

RMPFC Vision & Mission

RMPFC - Code of Ethics

Are you in agreement with the Vision and Mission and Code of Ethics of the Rocky Mountain Police & Fire Chaplains? (Y/N)

Do you agree to serve the Law Enforcement and Fire community with no agenda to proselytize them, or add them to your local Church. (Y/N)

Please submit this application along with a letter from your Church/Organizational Leadership Team stating their support of your involvement in Police & Fire Chaplaincy.

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The RMPFC Chaplain Application does not gaurantee membership within RMPFC or an emergency responder agency. You applicaiton is the beginning of the exploration of your calling and membership with RMPFC.

This application process will be reviewed by the Executive Director and Leadership Team and the content of this application will remain confidential.

Next Steps:
Once your application is reviewed, we will set up a meeting with you to discuss your application, any questions you may have, and look at opportunities together.

RMPFC requires all Chaplains to go through the RMPFC Basic Chaplain Training within one year of membership.

Annual chaplain agency dues are paid either individually or by the agency.

Digital Signature (By submitting this application, you attest that everything is truthful and accurate)

Date

Application Payment

Payment $35.00

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

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RMPFC Chaplain Application

Description

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