CFM 251: Ministry Practicum Application Form
Review the CFM 251 syllabus
here
before completing this application
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Student ID Number
*
ex. 12345
Email
*
example@example.com
Class
*
Freshman
Sophomore
Junior
Senior
Other
Check one or more of the following that apply. If your major is not CFM, please check the "other" box and enter your major.
*
CFM Major
CFM Minor
Discipleship Certificate Student
Leadership Certificate Student
Other
Academic Advisor
*
First Name
Last Name
Practicum Begin Date
*
-
Month
-
Day
Year
Date
Practicum End Date
*
-
Month
-
Day
Year
Date
Which semester is your Practicum taking place? (check all that apply)
*
Summer
Fall
Spring
Practicum Title
*
Practicum Site Name
*
Practicum Site Location
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Practicum Site Supervisor
*
First Name
Last Name
Practicum Site Supervisor Contact Number
*
Please enter a valid phone number.
Practicum Site Supervisor Email
*
example@example.com
Student Signature
*
Date
*
-
Month
-
Day
Year
Date
Practicum Vision Statement
*
Identify why you are entering into this ministry practicum and what you hope to accomplish or learn by the end of your experience.
CFM Objective Completion
*
Using the department objectives listed on the front page (with particular attention to column C "practically skilled"), identify specific and tangible ways you will address those three objectives. Also, highlight any other appropriate objectives you will meet with regard to "academically grounded" and "spiritually maturing." NOTE: requirements with CVC - 1) myStory interaction with CVC coach & 2) attend at least one Canvas program.
Submit
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