NAVAC PROFESSIONAL MEMBERSHIP
APPLICATION FOR NAVAC PROFESSIONAL MEMBERSHIP
Name ___________________________________________________
Mailing Address: ________________________________________________________
Work phone ___________________________
Home phone __________________________
E-mail address:__________________________
FAX: __________________________
VA Medical Center Address ________________________________________________________
Citizenship (USA required) yes no
Current position or employment:
Present association with VA
_______ Current chaplain, VA
_______ CPE Resident
_______ Retired chaplain
_______ Military chaplain
_______ Endorser
_______ Allied professional, please identify
_______ Other, please identify
Please remit this completed application, along with the $30.00 membership fee to:
NAVAC Certification Committee Chair
Chaplain David E. LeFavor, D.Min, BCC
Dayton VA Medical Center
Chaplain Service Code 125
4100 West Third Street
Dayton, OH 45428
NAVAC PROFESSIONAL MEMBERSHIP
There are two categories of membership. Category A members shall have all rights and Privileges of membership. Category B members shall have all rights and privileges of membership, except the right to vote, the right to hold office as either an officer or Board member, and the right to serve as a committee chairperson.
Category A members include any chaplain who is currently employed by the Department of Veterans Affairs in any of the following ways: a full-time employee, a part-time employee, an intermittent chaplain, a fee-basis
chaplain or a contract chaplain.
Category B members include CPE residents, retired and former VA chaplains, other federal chaplains to include but not limited to military chaplains, endorsers, and allied professionals with an interest in the VA chaplaincy.
Membership applications are to be sent to the Chairman of the Board of Directors. Appeals due to a person’s application not being accepted, is to the Board of Directors.
The fee for Professional Membership each year is $30.00, due and payable in January of each year. Should payment not be received by March 1 of each year, membership becomes inactive until such payment
is made.