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Contact Information

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Multiple File Upload

Please upload the following documents all at once before submitting your application at the bottom of this form. 1. Upload a copy of Board-Certified Chaplain Certificate. 2. Upload document showing minimally 400 hours of continuing education training in end-of-life issues. 3. Upload official letter of faith group or local church endorsement letter. 4. Personal Faith Essay: Create and upload a one-page essay of how you came to faith in Christ and about your current Christian walk.
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Max. file size: 50 MB.
    By typing my name on this line, I hereby certify the information on this application is true to the best of my knowledge. And I acknowledge that before this application is complete, I will have to submit my social security number upon request for a background check.

    Payment

    The annual $100 EOL-CSC fee is in addition to your annual BCC payment.