All Information Must Be Completed







Previous Clinical Pastoral Education

Attachments

Include significant persons and events (e.g. marriages, divorces, children, deaths, etc.) as they have impacted your growth and development. Describe your family of origin, current family relationships, and significant social relationships and their impact on your ministry. (20Mb File Size Limit) Two pages

Describe your faith development/history and include personal conversions, call to ministry, and significant persons and events that have impacted your spiritual growth and development. Indicate your current relationship with faith group-faith group authority person and present standing with your faith group. (20Mb File Size Limit) Two pages

Include a chronological list of jobs/positions dates of employment and a brief statement of your current employment and work relationships. A resume is sufficient. (20Mb File Size Limit) Two pages


(20Mb File Size Limit) Four pages a. Include the nature of the request, your assessment of the issue and a brief evaluative summary of what you did and how you helped. b. If you had prior CPE, please use verbatim format and indicate the most significant learning in your previous training.

(20Mb File Size Limit) One page a. Indicate what you believe CPE to be. b. Indicate if CPE is being required of you. c. List personal/professional strengths/weaknesses. List two learning goals for this program and how CPE training will help you address them. One page a. Please list personal/professional strengths/weaknesses. b. Indicate any personal/professional learing goals and how this training will address your learning and/or vocational goals.

You are required to complete an admission interview with an ACPE Supervisor or a person approved by the Center for which you are applying. Contact the local CPE center if you need help in locating an interviewer in your area. For residency, an on-site interview is a requirement.

WellSpan’s requirement is a submitted application by September 1 of the year prior to entry. You will have to obtain appropriate documentation from U.S. Immigration, which requires a visa and a US Social Security number. This documentation should be approved at least 6(six) months prior to the program. See http://www.acpe.edu/StudentsIntlStudents.html (ACPE website)