DCS Catechetical Certification
Religion Teacher Profile & Certification Application Form
Teacher Information
Name of Teacher (Nombre):
First Name (nombre de pila)
Last Name (apellido)
Address:
*
Street Address (calle)
Street Address Line 2
City(ciudad)
State(estado) / Province
Postal / Zip Code(código postal)
E-mail(dirección de correo electrónico):
*
example@example.com
Phone Number(número de teléfono)
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parish/Church where you worship regularly(parroquia/iglesia asiste regularmente):
Name and City(nombre y ciudad)
Pastor's Name(Cómo se llama su párroco):
Application for(¿Para qué es esta solicitud?) :
Basic Catechetical Certification (Certificación Catequética Básica)
Re-Certification & Renewal (required every 4 years) (Re-Certificación y Renovación (requerida cada 4 años)
Religion Teacher Profile only (Perfil del Profesor de Religión solamente)
School Information (Informacion de la Escuela)
Please indicate information for the location where you serve. (Por favor indique la información para la localidad donde usted sirve)
Current School Name (Nombre de la escuela actual):
ADLA Pastoral Region (¿Región Pastoral ADLA?):
Please Select
Santa Barbara Pastoral Region
San Fernando Pastoral Region
Our Lady of the Angels Pastoral Region
San Gabriel Pastoral Region
San Pedro Pastoral Region
Pastoral Region where the school is located?
School Type (Tipo de escuela)
Elementary (Primaria) (TK-8)
High School (Secundaria) (9-12)
Other
School Principal's Name (Nombre del director):
Principal's Email (Correo electrónico del director):
example@example.com
Role at the School (Función en la escuela):
Teacher (Profesor)
High School Campus Minister (Ministro del Campus de Secundaria)
Religious Coordinator (Coordinador religioso)
Principal (Director)
President (Presidente)
Other Administrator (Otro Administrador)
Staff (Personal)
Other
Current Teaching Status (Situación docente actual):
Full Time (Tiempo completo)
Part Time (Tiempo Parcial)
Not currently teaching (No enseña actualmente)
Grade(s) currently taught (Grado(s) impartido(s) actualmente) :
Pre Kindergarten (Preescolar)
Transitional Kindergarten (Jardín de infancia de transición)
Kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
Which Catholic Publisher(s) provides your schools primary source for religion/theology curriculum (check all that apply) ¿Cuál(es) editorial(es) católica(s) proporciona(n) a su escuela la fuente principal para el currículo de religión/teología? (Marque todas las que correspondan):
Saint Mary’s Press
RCL Benziger
Our Sunday Visitor
Pauline Books & Media
Ave Maria Press
Sadlier Religion
Liguori Publications
Sophia Institute for Teachers
Ignatius Press
Catholic Book Publishing
Paraclete Press
Liturgy Training Publications
Concerned Communications
Midwest Theological Forum
Twenty-Third Publications
Ascension Press
Center for Learning
Pflaum Publishing
Adventure Catechism Media
Augustine Institute
Barton Cotton
CR Publications
Franciscan Media
International Liturgy Publications
Paradisus Dei
Universal Publishing
Veritas Religion
Word on Fire
School/Parish resources
Other
Academic Background (Antecedentes Académicos)
Degrees/Certificates earned (Títulos/Certificados obtenidos)
Bachelors (Licenciatura)
Masters (Maestría)
Doctorate (Doctorado)
Credential(s)/Certificate(s) (Credencial(es)/Certificado(s))
Other
Theology/Catechetical related degrees/credentials/certifications earned (Títulos / credenciales / certificados obtenidos relacionados con Teología/Catequesis)
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Please upload copies of any theology/religious studies related courses, academic degrees, diplomas, transcripts, etc...If applicable, please include proof of Basic Catechetical Certification and/or Master Catechist Certification.
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Please list any religious conferences, workshops, and other enrichments programs you have attended in the past 5 years (Ex. Religious Education Congress, Sophia Institute, Liturgical Conferences) (Enumere las conferencias religiosas, talleres y otros programas de enriquecimiento a los que haya asistido en los últimos 5 años (Ej. Congreso de Educación Religiosa, Instituto Sophia, Conferencias Litúrgicas)
Please list any recent literature you have read in theology, spirituality, religious education, etc... (Por favor, enumere cualquier literatura reciente que haya leído sobre teología, espiritualidad, educación religiosa, etc...)
If applicable, please indicate where and when you completed Basic Catechetical Certification (Si aplica, por favor indique dónde y cuándo completó la Certificación Catequética Básica (fecha y lugar):
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Teaching Experience
# of Years teaching at present school:
# years teaching at another Catholic School:
# of years teaching at other non-Catholic schools:
Total # of years teaching:
Subject Areas presently teaching:
Social Studies, Math, Language Arts, Science, Religion/Theology, Visual & Performing Arts, Health/PE,
New Subject Areas you will be teaching:
Mark N/A if not applicable
Please check all the age levels in which you have experience as a catechetical teacher/formator:
Early Childhood (ages 2-5)
Primary grades (1st - 3rd grade)
Elementary grades (4th & 5th grade)
Middle School/Jr. High (6th-8th grade)
High School (9th grade)
High School (10th grade)
High School (11th grade)
High School (12th grade)
College/University
Campus/Youth Ministry
High School Confirmation
Other
Please describe any other related teaching and/or catechetical experiences and include the dates and locations associated with that experience
Include any work as a parish catechist, Confirmation teacher, youth ministry leader, etc...
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Short Essay Questions
The Personal Qualities of a Catechist. The Church calls forth exemplary followers of Christ who have a living, conscious, active participation in the sacramental life of the Church. Personal qualities of catechists include: • faith that manifests itself in their piety and daily life; • love for the Church; • apostolic spirit and missionary zeal; • love for their brothers and sisters and a desire to give generous service; • a willingness to continue their own religious education and formation; • the human, moral, and technical qualities necessary for the ministry of a catechist such as dynamism and good relationships with others; • respect for the diversity of cultures; • an ability to appreciate different stages of individual growth and development; • an ability to communicate effectively with the persons to be catechized.
Describe ways in which the personal qualities of a Catechist are reflected in your life. What are some qualities you would want to grow in?
What is your main reason for wanting to complete the Basic Catechetical Certificate? What do you expect to give as well as gain from your participation?
What is your philosophy of catechesis? How would you implement this philosophy in your teaching ministry?
Describe your understanding of God's revelation. What impact does this revelation have in your life? What implications does it have for teaching the Catholic faith?
Do you have a Spiritual Director? Would be interested in seeking one?
Yes, I currently have a spiritual director.
No, I do not have a spiritual director, but would be interested in seeking one
No, I do not have a spiritual director and I am not interested in seeking one at this time
I had a spiritual director previously and would be interested in seeking one again
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References
Please list (3) references with contact information
Reference #1
*
Reference #2
*
Reference #3
*
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