Chaplin Services Form Name (required) Email (required) Name of Church (required) Street Address Street Address 2 City State ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Phone Date Requested (Required) Start: End: Please Check if you agree to the following: All organizations that wish to participate and or hold religious meetings must register online. To be scheduled for the following month, the deadline for registration each month is the 20th of each calendar month. Any requests received after the 20th, may be scheduled for the month after. All participants in religious services must complete a background check or provide one that has already been completed to the JAIL ADMINISTRATOR. No person who has a FELONY CONVICTION or has been released from a detention facility within one year may participate in the organizations religious services. Due to our facility being classified as a Pre-Trial facility, most inmates will have the opportunity to continue their religious preferences once released. As a result of security protocols, no BAPTISMS shall be conducted at this facility. As baptism is an act of outward obedience, ones salvation is not affected on whether someone is baptised or not. Due to additional security protocols, men will minister to men and women to women only. Thank you for your ministry services to our facility. GOD speed!