Sonoma Law Chaplains Application

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: Are you interested in becoming a volunteer lay Chaplain for The Law Enforcement Chaplaincy Service in Sonoma County?

		Please review the information on the Would you like to be a Chaplain? page and download our brochure. If you would like to apply to serve as a Chaplain, please fill out our online application below. When the application is complete, please click the "Send Application" button. In addition, please send a reference letter to: Deputy Senior Chaplain BreeAnn Crespan LECS Academy Director Email: info@sonomalawchaplains.org

		First Name *		Last Name *

		Current Residence *

		City *		State *		Zip Code *

		Home# *		Cell# *		Work# *		E-mail Address *

		Driver's License# *		Exp. Date *		State *

		Date of Birth *		Age *		Place of Birth *		Marital Status *

		Education: * List high school(s), college(s), and post-graduate work. Name of School \| City & State \| Attendance From/To \| Graduated \| Major

		Training: * Program \| Location \| From/To \| Purpose \| Completed

		Employment History: * Begin with your current employer and provide the last three (3) places of employment. Please include laspe in employment. Organizaton \| City & State \| From/To \| Job Title \| Paid or Volunteer

Arrest Record: *
Either as an adult or as a juvenile, have you every been arrested?

Yes

		If Yes, please explain:

Conviction Record: *
Were you convicted of a crime?

Yes

		If Yes, please explain:

		Law Enforcement Experience: * Please tell us about any contacts or experience(s) you have had with Law Enforcement whether they were positive or poor.

Are you currently participating in a spiritual/worshipping community?

Yes

		If Yes, complete the following:

		Name of Organization:		Address:

		Phone#		Leader we may call:

		Your Position:

		If No: Please write a paragraph describing your spiritual life and/or faith and from where you draw emotional and spiritual support from.

		How did you hear about this program? *

		Why do you want to be a Law Enforcement Chaplain? *

By submitting this application, I confirm that I have read and I understand the qualifications and requirements for the position of Law Enforcement Chaplain and state that everything on this application is true.

* Required to submit this form

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(707) 538-4700 P O Box 15167, Santa Rosa, CA 95402
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