MDNG: Chaplain Contact

Providing Religious Support and Spiritual Leadership for Maryland's Citizen-Soldiers Since 1775

Maryland National Guard Join Force Headquarters Chaplain

Fifth Regiment Armory

Baltimore, MD 21201-2288

Office (410-576-6124)

Cell (443-992-5395)

Fax (410-576-6036)

Email Us

Visit our GKO Page

Chaplain Service Request Form

This office will strive to respond to all requests for assistance as soon as possible.

1. Date:

2. Title (Mr, Ms, LTC, 2LT, etc):
First Name: Middle Initial:
Last Name:

3. Relationship to Guard Member:

4. Home Address of Person Requesting Services:

Street Address:
City:
State:
Zip Code:
Your E-mail Address:

5. Daytime Telephone Number: () - Extension:
The Best Time to Reach Requestor:

6. Type of Request: Partners In Care Chaplain Services Recruiting

7. Reason for Request:

****This form uses your desktop program such as Outlook Express, etc to send as an e-mail. If you are having trouble submitting this form on-line, you can print this page and submit it via fax to the Chaplain's Office (410) 576-6036.