CPE Application

Spiritual Living Center for Education & Training is an accredited Training Center of Clinical Pastoral Education International and the College of Pastoral Supervision & Psychotherapy (CPSP). This application will suffice for application with SLCET for credit towards certification with either or both accrediting bodies.

PLEASE READ THIS APPLICATION FORM CAREFULLY. INCOMPLETE APPLICATIONS OR APPLICATIONS SUBMITTED WITHOUT AN APPLICATION FEE WILL NOT BE PROCESSED.

Please complete and click submit at the bottom of this form. You may want go the last section first and copy the essay questions and complete in another program such as Word and then copy and paste your answers into the fields.

You may pay your $125 application via credit card below. If you are applying within 2 weeks of the unit you wish to take, you must pay an additional $100 via the correct payment button below before your application will be processed. Your application fee is non-refundable.

Paying online for your application fee DOES NOT SUBMIT YOUR APPLICATION. You must complete the form and hit submit at the bottom of this form.

$125 Application fee BEFORE 2 weeks from start of the unit:

$225 Application fee WITHIN 2 weeks from start of the unit:

I am applying for the following CPE Unit:

Winter 2023 - General CPE Unit

Winter Hospice & Palliative Care CPE 2023 (Feb- April)

Spring 20223(April-June)

Summer 2023 (June-August)

Fall 2023 (Sep-Dec)

Select your CPE Supervisor for the Unit:

Rev. Dr. Paula Belleggie

I understand that I must send payment via Zelle from my bank to revpmb@slcet.org $125.00 (non-refundable) in order to have this application processed. I can also pay by credit card by using the Buy Now button. I will need to return to the site and complete my application and click SUBMIT at the bottom of this form. IF I am applying 2 weeks or closer to the start of a unit I wish to take, I understand the Application Fee is $225. If I am accepted into CPE with SLCET, I will also register online once registration is open for the CPE Unit I want to take to reserve a space in the class and I will do so.

I understand

I also understand that I need fill-out this application only if this is my first CPE Unit with SLCET and that I am also required to interview before being accepted for admission into CPE.

I understand

Full Name

First Name

Last Name

Date of Birth

YYYY

Email Address

Title

Rev., Minister, Rabbi, Lay Minister, RScP, Imam, etc.

Present Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Cell Phone

(###)

###

####

Home Phone

(###)

###

####

Work Phone

(###)

###

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Faith Group/Denominational Affiliation

Diocese, Presbytery, Synod, Ward, Parish, Center, Community, etc:

EDUCATION

Degree

Date of Graduation

YYYY

Seminary?

Graduate Study

Other Theological/Spiritual Training (Practitioner, Stephen Ministry etc.)

Where?

Date of Completion

YYYY

Other Significant Experience (Military, Missionary, etc.):

EXPERIENCE

Recent Positions held. Please include what you were doing, where and dates. Last ten years is enough unless it is pertinent to your ministry.

REFERENCES WITH CONTACT INFORMATION:

Please include a Denominational/Ministry Reference. an Academic Reference and a Personal Reference.

ESSAY: • A description of your life story including: Important events, relationships with people who have been significant to you, and the impact these events and relationships have had on your development. Be sure to describe your family of origin and your current family relationships. Include a description of the development of your religious/spiritual life, including events and relationships that affected your faith and currently inform your belief systems.

ESSAY: • An account of an incident in which you were called to help someone, including the nature of the request, your assessment of the “problem,” what you did, and a summary evaluation. (If you have had previous CPE, include this information in a case study with verbatim format.)

ESSAY: • Your impression of Clinical Pastoral Education and your educational goals, including how this training will be used to meet your goals for doing ministry.

Your Resume (covering at least the last 10 years)

You may copy and paste your resume into this field box.

Did you remember to pay your application fee via credit card above Your application cannot be processed without your application fee. Thank you!