Please check the membership category requested. (Member or Associate Member)Membership in this Association shall be open to all ordained and/or ecclesiastically endorsed persons who are currently or have been previously employed as a chaplain in a healthcare within the Commonwealth of Virginia. Membership is also open to all ordained and/or ecclesiastically endorsed persons who are currently engaged in volunteer chaplaincy in a healthcare institution within the Commonwealth of Virginia. ____ Member Annual Dues: $25.00
Associate Membership in this Association shall be open to professional persons or students who do not meet the requirements for membership, but who indicate interest in the purposes of this Association. Applicants shall be admitted to Associate Membership following the receipt of a formal application, recommendation by the Membership committee, approval by the Association, and payment of current dues. Associate Members have all privileges of membership except the right to vote or hold an elective office.
____ Associate Member Annual Dues: $10.00
If this is a renewal only, fill out sections below where there are changes in information previously provided.
Current Position/Title: _____________________________________________ Full time ____ Part time ____ Volunteer ____
Print This Page and Mail Check And Completed Application To:
Chaplain Bette Goglia, BCC -- VCA Treasurer Mary Washington Home Health & Hospice 5012 Southpoint Parkway Fredericksburg, VA 22407
Annual Scholarship Application
The purpose of the Virginia Chaplains Association is to: Offer opportunities for networking and collegial exchange for those engaged in chaplaincy and related pastoral ministries. Provide educational opportunities for professional chaplains, which are instructive and nurturing. Serve as a resource, advocacy, and consultative agency for groups and institutions that are exploring, establishing, or seeking to improve chaplaincy programs.
The VCA offers an annual needs-based scholarship of $300 to a student, who is a permanent resident of Virginia and is enrolled in or accepted to an accredited CPE Program.
Date ______________________ (Must be post-marked by September 15st)
Name __________________________________________________________________
CPE Center Phone _________________________________________________________
I am a permanent resident of the Commonwealth of Virginia _______ (Initial)
Signature _______________________________________ Date __________________
Attach a brief explanation of your interest and goal in CPE. Provide a statement of your financial need, including what sources of income you have to finance your education.
Send completed application to :
Chaplain Bette Goglia, BCC Mary Washington Hospice 5012 Southpoint Pkwy. Fredericksburg, Virginia 22408
The VCA Scholarship will be awarded at our annual conference held during the first week of October. If awarded the scholarship, attendance would be greatly appreciated and assisted if needed. Scholarships will be sent directly to the CPE Center.
