Chaplain Fellowship Ministries
3833 N.W. 20th Street
Oklahoma City, OK 73107Senior Citizens Membership Renewal Form
Please Note: Documents will be sent to the address you list below, please make sure you list the address where you want your documents to be sent.
Name: _______________________________________ Date: ________________
Address: __________________________________________________________
City: ________________________ State: _______________Zip Code:_________
Home Phone (____) _________________Business Phone (___)_______________
Email Address: _____________________________________________________
Date of Birth: _______________________ Age: __________ Sex: ___________
Marital Status: [ ] Single [ ] Married [ ] Divorced [ ] Remarried [ ] Other
Hair Color: ______ Eye Color: ______ Height: _____Weight: ______
I have been a member Since: Date: __________________________________
My CFMOK ID Card Number is: ________________________________________
My membership expired on: _______________________________________
(No Application for renewal will be processed without all required information being completed)Make sure you read this carefully before signing. No application for renewal of membership, license or endorsement will be considered or processed without this application being completed in full, signed, and dated. All renewal packages may take up to 3 to 4 weeks for delivery once received at the home office.
Please Note: Any member who make a firm commitment of financial support of at least $25.00 a month for the stability and advancement of Chaplain Fellowship Ministries Oklahoma will have their membership automatically renewed each year. Basic chaplains are renewed as registered chaplains after their first year.
SENIOR CITIZEN'S MEMBERSHIP RENEWAL: I am requesting to renew my membership as a senior citizen. My donation of __________$55.00 to cover my membership document production, ID Card and mailing cost and recording of all documents is enclosed.
1. This year I am making a monthly financial commitment of at least $10.00____$15.00 ___$25.00 ____$45.00 ____$65.00 ____$75.00 ____$100.00 _____for the stability and future advancement of Chaplain Fellowship Ministries.
1. Unscriptural conduct, failure to maintain membership requirements in good standing, or doctrinal departure from the tenets of faith, shall be considered sufficient Grounds upon which any person may be disqualified and removed as a member. Such discipline shall be prayerfully administered according to Scriptures by the Governing Board of Directors (Matt. 18:15-17; Rom. 16:17; 1 Cor. 5:9-13; 2 Thess. 3:6). I understand that if I am ever charged with, accused of, investigated for, moved or removed because of, or transferred to another position because of alleged criminal and/or sexual and/or ethical misconduct that this document authorizes my employer or volunteer chaplaincy organization to release all information to Chaplain Fellowship Ministries or their designated investigating agency.2. I understand that I am responsible for my own actions and that Chaplain Fellowship Ministries and all associate Churches, ministries, ministers and Chaplains shall not be held liable for any damages caused by the misuse or misrepresent of my qualifications, credentials or experience. Please Note: New membership packages may take up to 3 to 4 weeks for delivery once received in our office.
Signature Is Required: _______________________________________________ Date: _______________
Personal information is not published, sold or given to outsiders: All personal information given is Strictly Confidential; it is only used for confirmation of your endorsement and certification which is logged in our legally licensed Ministers ledger and recorded for duly authorized ministry verification purposes only. Any alterations to this form will cause it to be void and application will not be considered. In such case the application will be returned to the applicant along with any donations made for consideration for the requested membership renewal and membership will not be reconsidered.
Checks or Money Orders: All funds must be in US funds: Make payable to: Chaplain Fellowship Ministries, Mail your completed renewal form with your check or money order to the home office listed below.
For ministry home office use onlyDate Renewal Form was received : _________________
Date Renewal Form was reviewed: _________________
Approved on:___________________________________
Disapproved on: ________________________________
CFMOK File No: _______________________________
Comments or Recommendation:
Signatures of senior staff members reviewing renewal form.
Chaplain: ______________________________________
Chaplain: ______________________________________
Chaplain: ______________________________________
Please Note: Unscriptural conduct or failure to maintain membership requirements in good standing or doctrinal departure from the tenets of faith shall be considered sufficient Grounds upon which any person may be disqualified and removed from membership. The requirements and information required within this application shall be subject to change without notice. The board of directors does hereby have the right to refuse membership renewal for Unscriptural conduct or failure to maintain membership requirements in good standing. All decisions made by the board of directors has be final and binding. No goods or services were provided for this donation other than intangible religious benefits.