Ad Hoc Endorsement Request Form

In order to help our Secretary for Prison Chaplaincy, Bob Wilson, progress your requirement for Faith Endorsement, please fill in the following form and he will be able to progress your request as soon as possible.

Name *
Date of Birth
Date of Birth
See note below

[note ref Referee - should be your Senior Pastor if Volunteer Chaplain, or someone in National or Regional Oversight of Prison Chaplaincy if a paid role eg. District Chair / Regional Minister]