Reader Training Registration Form

Licensed Lay Minster (Reader) Training Application

Use this form to apply for the LLM(R) Training Programme
Name*

First NameMiddle Name(s)Last Name
Other Names*
Any other name you have ever been known by (please state 'None' if there are none.
Birth Date*

DayMonthYear
Gender
Address*

Street Address

Street Address Line 2

CityCounty

Postal / Zip Code
E-mail*
example@example.com
Mobile Number
Phone Number

Area CodePhone Number
Emergency Contact Name*
Emergency Contact Number*
Church
Vicar / Supervisor's Name*
Vicar / Supervisor's Email*
Vicar / Supervisor's Phone Number*
Deanery
Your Occupation
Training & Experience
Please state if you have ever been on any ministry training course (including Ordination Training), have explored any other kind of ministry (including Ordination), have any relevant theological training or professional training, or any training you have undertaken in your church or the Diocese. Please also state any experience of ministry in your church or other churches that you have had to date (take as much space as you need to do this).
Safeguarding Declaration
Please state if you, or anyone in your household, has ever been refused a DBS certificate or implicated in any Safeguarding situation. if not please state 'Nothing to declare'. .
I have read and understand the Information Pack*

YesNo
I understand that I am applying for the Reader Training Course and that I will start in Autumn Term (September) subject to the written agreement of my incumbent or Area Dean (see below) and clearance from Safeguarding*

YesNo
Signature*

Clear
Date*

DayMonthYear
Date
In order to facilitate the practical training we need a statement of support from whoever has responsibility for your church to state that they are happy to allow you to carry out the practice placement components of the course and also to give some feedback on what you have done. For Trainee Readers, incumbents (or a named supervisor in a Vacancy) will also be required to give feedback on your practical assignment for each module, using a feedback form. Incumbents/Area Deans will also need to state whether there is anything of which they are aware which may limit, or impact upon, a student's ability to undertake public ministry.

Please therefore make sure that you have completed your incumbent's name and email address so that we can request this statement from them.
Should be Empty:

Licensed Lay Minster (Reader) Training Application