Clergy Application for Emmaus Team

Clergy Application for Emmaus Team
Name*

First NameLast Name
Name you like to be called:
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Preferred Phone Number*
Please enter a valid phone number.
Preferred Email*
example@example.com
Your Church Relationship
Are you an ordained minister?*

YesNo
Date of ordination

MonthDayYear
What is your clergy status?*
(i.e. license, certified, deacon, etc.)
In what church or denomination?*
What is your current professional ministry?*
(i.e. pastor, chaplain, etc.)
Full or Part Time?*

Full-Time MinistryPart-Time Ministry
If a pastor, church(es) you currently pastor:*
Your educational background: Please list the theological school(s) you have attended, the date(s) of graduation(s) and degree(s) you have earned in your ministerial training:*
School - Year - Degree
Are you a retired minister in good standing?*

Yes (enter home church below)No
Home Church
Your Emmaus and Chrysalis background (Where and when did you make your Emmaus Walk, or other 4th Day weekend?):*
Have you attended an Emmaus/Chrysalis clergy training conducted by The Upper Room staff or a Clergy Regional Representative?*

YesNo
If yes, date & community:
Previous Team experiences as a layperson (Please list by Community name followed by Walk/Flight/Journey number, jobs held, talks given)*
Previous Team experiences as a clergyperson (Please list by community name followed by Walk/Flight/Journey number)*
For the Emmaus and Chrysalis Clergy talks listed below, please check all that you have given.

Prevenient GraceGod Designed YouJustifying GraceGod Loves YouMeans of GraceGod's Gift to YouObstacles of GraceGod Sustains YouSanctifying GraceGod Empowers You
Have you ever served as the Weekend/Head Spiritual Director on a Walk/Flight/Journey?*

YesNo
If yes, give the community name and Walk/Flight/Journey number:
What Emmaus/Chrysalis Community Activities have you participated in?*

Group ReunionGatheringsSponsors HourCandlelightBackground serviceClosingsSponsoringAgape SupportCommitteesBoard MemberHootOther (Explain)
Expected team participation:
Team formation is a 17 to 20-hour process prior to the weekend event. In the Dayspring Emmaus
Community, we gather at Orientation, Formation, Team Building, and Dedication. It is
understood that clergy are expected to attend all of the team meetings and preview their talks at
Formation. Specific team meetings that you would need to miss are coordinated with the
Weekend Spiritual Director and the Weekend Lay Director. There shall be at least two clergy
persons (WSD & AWSD) who will stay for the entire weekend for purposes of training and
support. All other clergy are expected to attend the entire weekend plus Follow-Up if possible.
Signature of Applicant*

Clear
Date*

MonthDayYear
Please verify that you are human*
Should be Empty:

Clergy Application for Emmaus Team

Your Church Relationship