Please complete this form for each board certified APC member nomination submitted. The deadline for award submissions is April 15, 2023.
Accompanying documents can either be uploaded as part of this form or sent to the APC office separately.
Please use this space to upload the documents that must accompany this nomination. If you would prefer another format, please either e-mail them to firstname.lastname@example.org or mail them by the deadline to:
Association of Professional Chaplains, 2800 W. Higgins Rd., Suite 295, Hoffman Estates, IL 60169