Membership – Association of Professional Chaplains Kenya

ASSOCIATION OF PROFESSIONAL CHAPLAINS IN KENYA (APC-K) MEMBERSHIP APPLICATION FORM

Section A: Applicant’s Personal Information

1. Full Name (as it appears on official documents) *

2. National ID / Passport Number *

3. Date of Birth (optional) *

4. Gender (optional)

Female

Male

Prefer not to say

Other

Section B: Contact Details

5. Postal Address *

6. Physical Location (County / Town) *

7. Telephone / Mobile Number *

8. Email Address *

Section C: Membership Category

Depending on your qualifications and experience, you may be considered for

a) Life membership
b) Full member
c) Associate Member

Section D: Chaplaincy Context & Employment

9. Current Chaplaincy / Spiritual Care Role (Title) *

10. Primary Setting of Practice (tick all that apply) *

Other (specify)

11. Employer / Institution / Organization *

12. Length of Experience in Chaplaincy / Spiritual Care *

Less than 1 year

1–3 years

4–7 years

8+ years

Section E: Interfaith & Professional Orientation

13. Chaplaincy Practice Context (tick all that apply) *

Interfaith / Multi-faith

Ecumenical

Faith-specific within plural institutions

Secular or public service setting

14. Briefly describe your experience working in religiously and culturally diverse settings (150–200 words) *

Section F: Professional Experience /Education, Formation & Training

Other:

16. Field(s) of Study (e.g. Chaplaincy, Theology, Religious Studies, Psychology, Counseling, Social Work) *

17. Institution(s) Attended

18. Professional Chaplaincy / Spiritual Care Training (if any)

19. Chaplaincy Experience in years *

1- 2 years

Over 2yrs - 5 years

Over 5 years - 10 years

Over 10 years

20. Institution(s) served as Chaplain *

Section G: Professional Commitments & Ethics

Please confirm by ticking Each box:

I commit to interfaith respect, cultural humility, and non-proselytizing practice in institutional settings *

I commit to uphold the Code of Ethics and Professional Conduct of APC-K

I commit to interfaith respect, cultural humility, and non-proselytizing practice in institutional settings

I affirm accountability, confidentiality, safeguarding, and professional boundaries

I commit to continuing professional development (CPD)

I affirm chaplaincy practice that respects African moral worlds, relational personhood, and community-centered care

Section H: Referees (Professional) *

Please provide details of one professional referee familiar with your chaplaincy work.
(Name, Position / Organization, Email, Telephone)

Section I: Declaration

tick *

I declare that the information provided in this application is accurate to the best of my knowledge. I understand that membership in the Association of Professional Chaplains in Kenya (APC_K) is subject to review and approval in accordance with the Association’s constitution and regulations.

Applicant’s Signature: *

Date: *

Attachment

Curriculum Vitae

REGITRATION FEES *

Ksh. 3000 or $30 Onetime Registration (Full member: A person who fulfils the requirements for membership)

Ksh. 200 or $2.40 Monthly Subscription (Associate Member: Other professionals or students with demonstrated interests through research in spirituality or has attained 10 units of Chaplaincy Professional Development)

Ksh 50,000 or $500 Life Membership (A person who expresses exceptional interest and commitment to APCK objectives and values shall pay a one-time registration)

MPESA
Paybill: 522522 Account No: 1348909919

Bank Payment Details
Name of the Account: Association of Professional Chaplains in Kenya
Name of Bank: KCB Bank, KIKUYU

Once you have paid, please sMS the payment details to the Treasurer Prof. Kirika at +254 722 771 276

Association Contact Information
Physical Address: Chaplaincy Training Centre,
next to Mother and Baby Hospital, Moi Teaching and Referral Office,
ELDORET, Kenya.

Phone: +254 715 653 017

Email: info.apckenya@gmail.com ; info@chaplaincy.co.ke