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    Your Congregation

    Your Address

    Your City

    Your State

    Your Zip Code

    This form is to certify that the Congregation listed below will complete the following

    1. We agree to adopt or implement one or more Military Ministry Programs

    2. We agree to advertise the existence of the Military Ministry Program(s) in one or more of our congregation publications (service bulletins, newsletters, etc.) so that their existence is easily visible to visitors, members, and leadership of the congregation

    3. We provide permission to the Military Chaplains Association and their affiliates to list our congregation information on their web site

    Optional. We would also like to be a Lead Congregation and help establish Veteran/Military Ministries in parishes and congregations in our vicinity


    Choose Category

    Clergy first and last name

    Clergy Title

    Clergy email

    Clergy phone number

    Lay Leader Contact Info:

    Lay Leader first and last name

    Lay Leader email

    Lay Leader phone number

    I consent to conditions 1, 2, and 3 above.