Membership form - Public Safety Chaplain
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The membership fee is $150, paid upon approval by the institution. Its approval may take up to 15 days.
Name*
Address*
State*
City*
Zip code*
Phone*
E-mail*
Birth date*
Naturalness*
State*
driver license*
Indicated by*
Father's name
Mother's name*
church you belong to*
Since*
Position or function that you occupy*
Since*
Presiding pastor*
church phone*
Do you have a course in Theology?*
Sim
Não
Institution name*
What is your school level?*
Institution Name*
Mark your vocation to the chaplaincy
Hpspital
school
Prison
Public security
Asylum
Other
Infant
Business
Outra
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