Bi-Annual (non-military) Report This form is for non-military chaplains (see Ministry Area below). Current non-military chaplains are required to submit this report twice a year (January and June). Submission deadlines are January 31 and July 31. Ministry Area VA Medical Center Hospital Hospice Nursing Home Retirement Center Law Enforcement Prisons Civil Air Patrol Campus Motor Cycle Industrial Seminarian Other Personal InformationName First Last Ministry Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Office/Cell PhoneHome PhoneWork Email Personal Email Pending Changes of StatusPromotion ToPlease indicate date of promotionIf you are leaving you current position or retiring; when will that take place:Is there any other changes to ministry or status that we should be made aware of? When will that take place?Ministry ReportSome Of My Greatest Blessings In The Last Six Months WerePlease Pray ForPastoral ActivitiesPlease quantify the following activitiesWorship ServicesBible StudiesOther Small GroupsOne-On-One VisitsOutreachPlease quantify the following activitiesFirst Time DecisionsRededicationsBaptisms