School / College Chaplain Induction Eligibility Form
Thank you for expressing an interest in the School College Chaplain Induction Programme delivered by The Centre for Chaplaincy in Education and Newman University.

In order to process your registration, please can you complete the following form.

Please note the Course is only intended for Chaplains in Schools and Colleges.
It is only open to Chaplains who have been in place for three years or less.

Please note that the purpose of this form is to etablish your details and a referee in a school / college who we can contact to confirm your identity and that DBS checks have been completed.

We are aware that some applicants may hold positions across multiple schools / colleges. Where this is the case, please can you provide us with the details of one School / College the one where your referee is based.

Email *
First Name *
Surname *
Middle names
Date of Birth (DOB) *
Your current home address *
House Number/Name, Street Name, Town/City, County, Postcode
Mobile number *
Landline number
Are you an Education Chaplain? *
In what setting(s)do you currently work *
Please check all that apply.
Do you work with more than one school / college? *
Have you been practicing for 3 years or less? *
How many years have you been practicing? *
Please provide the name of your current school / college *
Please see notes at the top of the form should you pratice in more than one school / college.
Please provide the address of your current school / college. *
Street Name, Town/City, County, Postcode
Please provide the telephone number for your current school / college. *
Please provide the name of a referee from your current place of work. *
Please note that we will be contacting all referees by telephone to verify your identity and your length of service. All participants will require their identify to be verified before commencing the course.
Referee telephone number *
Referee email *
Professional relationship with referee *
A copy of your responses will be emailed to the address you provided.
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