Application for Registration

Please complete and submit this form to begin the process to become a UKBHC registered chaplain.

Why am I being asked for a Fee?

The fee covers the costs of processing your application, and, on the assumption that your application is successful, the first year registration fee. Fees have been calculated to cover the costs of registration through the Professional Standards Authority for Health and Social Care.

How do I pay?

This system for collecting and recording annual registration/membership fees is integrated into the UKBHC website and database, reducing the admin work required and so helping to keep fees low.

Is it secure?

Our system uses Paypal's secure service to handle the transaction. You don't need to have a Paypal account, you can make a payment quickly and safely using any major debit or credit card. Your card details are never entered or stored on our website. This sensitive information is only ever handled by Paypal. For more information about security and Paypal please see their website.

UKBHC Register: Application and First Year Membership)

Please select the appropriate option below. You will have a chance to review your selection on the next page prior to your debit/credit card being charged.

Membership type *

Registered UKBHC Member - £ 60.00

Provisional/Student UKBHC Member - £ 30.00

Total Amount

Fields marked with an asterisk are required.

Initial Applicant Information

Title

First Name *

Last Name *

First and last name will be shared with other visitors to the site.

Street Address

Address line 2

Address line 3

Town/City *

Postal Code *

Contact Email Address

Phone

Please provide a phone number where we can reach you if need be. We won't contact you unnecessarily by phone, but this can be useful if, for example, you accidentally provide an inaccurate email address.

Date of Birth *

Gender *

Female Male

Current Employer *

Job Title *

Please provide the name of your employer, even if this is the same as the Organisation Name provided above as part of your contact address.

If for any reason you are unable to register for a user account on this website, or to complete the online application form for UKBHC registration, please contact us via email by clicking the link below, providing further details as to why this website is inaccessible for you.

We can provide you with an offline form to complete as an alternative.

Click here to let us know why this site is inaccessible for you, and to request an offline registration form.

The information you provide will enable us to improve the online experience for all users.