Request C.E.U. Equivalency for Class or Event
Name of Person Submitting Form
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First Name
Last Name
Email of Person Submitting Form (You will receive a copy of this application)
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example@example.com
What is the nature of this request?
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To get C.E.U.'s approved for a District Event.
To get C.E.U.'s approved for an individual class I have taken.
To get C.E.U.'s approved for an event I have attended.
Other.
If you chose other please share what you are requesting.
Class or Event Title
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Sponsoring Seminary or Organization
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Brief Description of Event or Class Including Title
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Date(s) class or event was offered:
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List instructors of class or event and denote their professional qualifications/agency/affiliation:
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Location of Class or Event
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For a class: attach your transcript or equivalent for class completion (does not have to be final transcript). For an event: attach a brochure, agenda, or the web address where the information about your event can be found:
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What characteristics in the Characteristics for Effective Clergy does this class or event address?
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Maturing Spirituality
Integrity and Authenticity
Sound Theology
Servant Leadership
Relational
Self-Care
Connectional
Adaptability
Performance Standards
Evangelism and Discipleship
Ministry Development
Proclamation
Commitment to Inclusivity
Visioning and Implementation Skills
Inspirational and Motivational Skills
Administration
Pastoral Care
Conflict Management
Number of instructional contact hours:
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Number of hours of additional preparation work or course work (if applicable):
For those offering an event: An evaluation is required for all events granting C.E.U.'s. How will your event meet these requirements?
For those offering an event: Once C.E.U.'s are approved by Clergy Excellence it is up to your organization to create and disburse certificates.
I understand that it is the responsibility of my organization to create and disburse C.E.U. certificate to participants upon the completion of the event.
Thank you for submitting this request. Clergy Excellence will get back to you with the amount of C.E.U.'s that have been approved.
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