Clergy registration form

A place to re-member: Clergy Group

Please register by filling in the form below
Filling out this registration form is an indicator of your interest in participating in a virtual group for clergy from EDLA. The group's purpose is to support each other emotionally and mentally as we provide care to God's people in the midst of the constantly changing circumstances, grief and trauma that comprise the after-effects of a global pandemic. This group will meet biweekly online on Tuesday afternoons or Saturday mornings. In order to create a better space for connection and enable genuine sharing, group size will be capped at 6 participants plus the facilitator.
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
What are you hoping to gain from participating in this support group?*
1st and 3rd Tuesdays at 1:302nd and 4th Saturdays at 9 amOther
Suggested donation for the 6 sessions is $100/person.*
These funds help cover costs for technology, ongoing supervision, and continuing education. However, if finances are tight, please do not hesitate to request a full or partial scholarship.
Once you have registered, Alene will contact you to sign the confidentiality and consent form and discuss potential starting dates. Thank you for joining us as we support each other!
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A place to re-member: Clergy Group