APC Retired Chaplain Award Nominating Form

Please complete this form for each retired board certified APC member nomination submitted. The deadline for award submissions is April 15, 2024.

Accompanying documents can either be uploaded as part of this form or sent to the APC office separately.

Nominee Information

Address(Required)

Nominator Information

Address(Required)

Accompanying Documents

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 info@apchaplains.org or mail them by the deadline to:

Association of Professional Chaplains, 2800 W. Higgins Rd., Suite 295, Hoffman Estates, IL 60169

Max. file size: 20 MB.
Max. file size: 20 MB.
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