Military Chaplain’s Form

Chaplain Military Form

Name
First Last
Rank*
Branch of Service
Unit Address*
Year and quarter which the following information applies to:*
Branch of Service*
Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Office / Cell Phone
Home Email
Work Email
Pending Changes of Status
Alerted for Transfer: Where and When
Promoted To: (please indicate date of promotion)
If you are leaving Active Duty when will that take place:
Is there any other changes to ministry or status that we should be make aware of? When will that take place?
Ministry Report
My Greatest Blessing This Quarter Was:
Please Pray For:
Worship Services
Bible Studies
Other Small Groups
Crisis/Suicide Interventions
Pastoral Activities: (Please quantify the following activities)
First Time Decisions
Rededication's
Baptisms

This form is for active-duty military chaplains and reserve chaplains.
Active-duty Chaplains are required to submit this report quarterly – (deadlines are January 31, April 30, July 31, and October 31).
Reserve chaplains are required to submit this report biannually – (deadlines are January 31 and July 31).

Military Chaplain’s Form

Chaplain Military Form

Ministry Report

Pastoral Activities: (Please quantify the following activities)

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