Application to be a Chaplain in the U.S. Military

All those interested in joining the U.S. Military as Chaplain should please fill out the

Please email a photo of yourself to signup@shulchanaruch.com, upon completion of this application

* indicates required field

First Name:*

Middle Name:

Last Name:*

Email:*

Re-enter Email:*

Message:

Address:*

Address: apt/suite:

City:*

State:*

Zip*

(non-US residents, enter 00000)

Country:*

Home Phone:*

Sample Number: 123-456-7890

Office Phone:

Fax Number:

Cell Number:*

Best Time to Call:*

Where did you hear about the site?*

Father's Name:*

Mother's Name:*

Applicant's Hebrew Name:*

Occupation:*

Hebrew Reading Skills:*

Yeshiva Background:*

Secular Education*

Do you have a Smicha?:*

YES NO

Who gave the Smicha?*

What areas did you learn?*

Status:*

Married Single Divorced Widowed

Age:*

Name of Shul you attend:*

Location of Shul:*

Rabbi of Shul:*

Rabbi's phone #:*

Rabbi's Email:*

Chaplain Form