Application for NAVAC Board Certified Chaplain
A person making application for Board Certified Chaplain must have the requirements of a Certified Clinical Chaplain as prerequisite. A total of 4 units of CPE are required.(Please see item #10 for CPE equivalency details)
Evaluation before a peer review board.
Annual membership for Board Certified Chaplain is $75.00.
NAVAC BOARD CERTIFICATION:
THE APPLICATION PROCESS
The application for Board Certification is sent to the Chairman of the Board of Directors.
A $100.00 one-time, non-refundable application fee is sent to the Treasurer.
$75.00 in dues is to be paid to the Treasurer on the next January 1st after acceptance.
If application is complete, it is sent to Chairman of the Certification Committee.
A convener is selected, who then selects three Board certified chaplains and up to three persons from other disciplines to serve in the interview process, known as the “peer review” (see Section entitled “Role of the Convener”).
Dues paying chaplains from APC, NCVACC, NACC, VA Black Chaplains, National Association of Jewish Chaplains (NAJC), CPE Supervisors, & ACPE – who are Board Certified by their own organization, may be invited to assist in panels. Only the NAVAC members of such panels are voting members of the panel.
A presenter is selected to read all the material and to send an outline to all other members; this must be done before the peer review (see “Role of the Presenter”) If an interview, which may take place face-to-face or by video-tel, is positive, the committee informs the candidate of its recommendation, and then notifies the Committee Chairman, who in turn informs the Chairman of the Board. Official recognition of acceptance of the candidate as Board Certified comes from the Chairman of the Board of Directors. All materials are returned to the candidate.
If the interview is negative, the Interview Panel notifies the Chairman of the Certification Committee, that….
Certification is not recommended; OR
Certification is deferred.
See the last Section dealing with the
Appeal Process.
APPLICATION FOR NAVAC
BOARD CERTIFIED CHAPLAIN
1. PERSONAL INFORMATION
Name________________________________ Title_______
Faith Group________________________
Mailing address____________________________________
Work phone_____________________
Home phone __________________
FAX __________________
E-mail address___________________________
Current member of NAVAC? ____________
VA Medical Center ___________________________
Position ______________________________
2. EDUCATIONAL BACKGROUND
College_____________________________ Degree________ Date_____________________________
Seminary___________________________ Degree________ Date__________________
Further education________________________________
Complete section below if requesting acknowledgement of equivalency for M.Div:
Institution____________________________Degree________ Date_____________________________
(Send transcript of credits & documentation of theological education if requesting M.Div. equivalency)
3. ENDORSEMENT
Endorsed by which faith group?__________________
Date ___________________
(provide copy of current endorsement)
Ordained or commissioned? ________
When & where______________________________
4. PROVIDE AN AUTOBIOGRAPHY OF YOUR FAITH JOURNEY. (not to exceed 2 typewritten pages)
5. COMPLETE AN UPDATED US GOVERNMENT FORM OF-612. (not to exceed 5 typewritten pages)
6. COMPLETE A STATEMENT OF THE RATING FACTORS FOR CHAPLAINS (KSAO’s).
Please describe your experience, education, training, “awards and other specific accomplishments that demonstrate your competencies.
Ability to communicate orally and in writing.
Describe your accomplishments in oral and written communication. Describe your use of these abilities in your professional experiencein religious instruction, pastoral care, and participation in multidisciplinary teams/committees. List and describe any publications.
Ability to provide pastoral care and counseling in a healthcare setting.
Describe in detail your experience in providing ministry in health-care settings. Describe the workplace, the type(s) of patients or clients served, and your participation as a member of multidisciplinary treatment team(s). Be sure to include any experience with veterans.
List any relevant training or education. Describe your qualifications in any clinical specialties and attach supporting documentation.
Ability to provide ministry in a pluralistic setting.
Describe your experience in relating with clergy, patients, and others from various faith and value traditions. Describe any accomplishments in developing interfaith relationships. Describe your experience in ministering to persons from a variety of faith groups.
Knowledge of worship principles and practices.
Describe your ministry experience and current professional practice that demonstrates your knowledge of various worship (liturgical) principles and practices.
Ability to establish relationships and deal effectively with others.
Describe your experiences in leading or supervising others.
Describe your involvement in community and civic activities.
Be sure to describe your relationships with professional associations, interdisciplinary
teams, veteran’s organizations, fraternal organizations, etc.
7. PROVIDE EVIDENCE OF PARTICIPATION IN CONTINUING EDUCATION.
8. GIVE A RESUME OF YOUR VA CHAPLAINCY EXPERIENCE.
9. PROVIDE AN ORGANIZATIONAL CHART OF THE SETTING IN WHICH YOU NOW SERVE THE VA.
10. SUPPORTING DOCUMENTS AND CLINICAL PASTORAL EDUCATION EVALUATIONS:
-Provide a current letter of ecclesiastical endorsement.
-Provide a letter from the Supervisor of Chaplains at the VA where you are employed.
-Provide two letters of recommendation from currently active NAVAC Board Certified Chaplains or chaplains certified with organizations with whom NAVAC has reciprocal certifications.
--Provide CPE evaluations or equivalencies.
-Provide documentation of 4 units of CPE or equivalencies.
Clinical Pastoral Education Equivalency
Only ACPE CPE is accepted as fulfilling the requirements for CPE training. Therefore, of the four units of CPE required for Board Certification, three of those units must be ACPE CPE. Only one unit of the 4 unit CPE requirement may be requested as an equivalency. For an equivalency experience to be accepted for one unit of CPE the equivalent training must contain the following components:
*A minimum of 400 hours of supervised clinical work with real living human documents.
*A didactic component that caused the candidate to reflect upon the integration of one’s personal story and their understanding of the behavioral sciences and theology.
*A group supervision of their work.*A regular opportunity for peer group / interpersonal relationships, development, and critique.
Time Frame for Certification
As NAVAC Certification Committee members are generally full-time VA Professional Chaplains, please expect that the certification process may take as long as 30 days for CCC applications and 90 days for BCC applicants once the completed application packets are received.
NOTE: SEND THE REQUESTED MATERIAL, ALONG WITH A ONE-TIME NON-REFUNDABLE CHECK FOR $100.00 MADE OUT TO NAVAC TO:
NAVAC Certification Committee Chair
Chaplain Thomas Mills (2014)
VA Illiana HCS
1900 East Main Street
Danville, IL 61832-5198
E-Mail: Thomas.Mills@va.gov
