Renewal Form INTERNATIONAL CHAPLAINS ASSOCIATIONINTERCHAP-GLOBALCREDENTIAL RENEWAL FORMRenewal for one year $39.00PROMOTIONRenewal for two years $70.00All fields with (*) are required Options:1 Year $39.002 Years $70.00 Badge #: Current Rank:SelectSub LieutenantSec. LieutenantFirst LieutenantCapitanMajorLt. ColonelColonel Full Name: E-mail: Address: Address 2: Town: State: ZIP: Country: DOB (mm/dd/yyyy): Gender:MaleFemale ID#: ID Generator: Home Phone: Cell Phone: Blood Type:SelectA+ PosA- NegB+ PosB- NegAB+ PosAB- NegO+ PosO- NegNot Identified Eye Color:SelectBrownBlackGreenBlueHazel Hair Color:SelectBrownBlackBlondRedWhiteGrayBold Hight: Weigth: Add Photo: Max. Size 2Mb (jpg, jpeg)SubmitEraseAfter submitting this form you will be directed to our payment options. Thank you and may God bless you!