How to apply to the Volunteer Chaplain Program
at Rady Childrens Hospital-San Diego
1. Please print out the application below and write in your responses
2. Mail to:
Rady Childrens Hospital-San Diego
Rev. Ryan Sey
Pastoral Care, MC 5086
3020 Children’s Way
San Diego, CA 92024
3. If you have any questions, please contact Rev. Ryan Sey at 858-966-7493 or .
4. For more information, please go to our website: www.rchsd.org/pastoral .
Application for Volunteer Chaplaincy Program
Name: Last______First______MI___
Home Address:______
City ______Zip Code ______
Phone: _(______)______
Email Address: ______
Pager #: ______
Mobile Phone #: ______
Congregational Information
Name of Congregation/Faith Community ______
Present Position Title ______
Religious Affiliation/Denomination: ______
Address of Faith Community ______
______
City______Zip Code ______
Phone: _(_____)______Fax #: ______
Education/Credentialing
College______
Degree/Major______
Seminary______
Degree/Major______
Other Education______
______
Ordained/Appointed [ ] Yes [ ] No Date:______Title:______
Religious Body that Ordained/Appointed you:
______
Clinical Pastoral Education (CPE)? Yes [ ] No [ ] # of Units Completed______Dates______
Location of CPE Center:______
Other Relevant Clinical Pastoral Training:______
Significant Ministry Experience
Place / Position / Dates / Type of MinistrySpecial skills/training pertinent to hospital and/or pediatric ministry?
Employment Experience
Place / Position / Dates / Type of MinistryWhat interested you in wanting to be a volunteer chaplain at Children's?
Foreign Languages Spoken: ______
Availability
Morning: M T W TH F SA SU
Afternoon: M T W TH F SA SU
Evening: M T W TH F SA SU
References
Please list three people we may contact who have known you for more than one year (excluding relatives).
Name ______Phone______
Address______
City______Zip Code______
Email Address: ______
How do you know this person?
Name ______Phone______
Address______
City______Zip Code______
Email Address: ______
How do you know this person?
Name ______Phone______
Address______
City______Zip Code______
Email Address: ______
How do you know this person?
Volunteer Chaplains must have state and federal background checks. Rady Children's Hospital San Diego reserves the right to conduct these. Volunteers are also expected to complete annual TB tests and Flu vaccinations.
Signature:______Date: ______