Renew Membership

2027 AFFC MEMBERSHIP RENEWAL

Full Name

Membership ID#

Address

City

Zip

County

Birthdate

Phone

Sex

Marital Status

Anniversary

Spouse's First Name

Spouse/Emergency Contact#

Position

Appointing Department

Station#

Chief's Name

Chief's Phone

Department Address

City

Zip

Endorsing Church

Denomination

Pastor's Name

Pastor's Phone

Church Address

City

Zip

Highest Education Level

Degree Title

Have you ever been employed in Public Safety (law enforcement, fire, medic, EMS, etc.)?

Have you ever served as a Chaplain?

Current Employer (if Retired, Department or Employer Retired)

Supervisor's Name

Supervisor's Phone

Employment Address

City

Zip

Detailed Personal Testimony

Additional Training Needs (Request Form is located in Training Events)

Introduction to Fire Chaplaincy

Pastoral Crisis Intervention

Stress Management & Self-Care

Other

Alabama Fellowship of Fire Chaplains

Est. 2012

2027 AFFC MEMBERSHIP RENEWAL

Other Contacts

Alabama Fellowship of Fire Chaplains Est. 2012

2027 AFFC MEMBERSHIP RENEWAL

Other Contacts

Alabama Fellowship of Fire Chaplains

Est. 2012