Psychological Assessment Registration
Name
*
First Name
Last Name
Date of Birth
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
What is your primary language?
*
English
Spanish
Other
If other, specify primary language.
Would you like the Psychological Assessment Package to be in a language other than English?
*
Yes.
No.
If so, what language?
Gender
*
Please Select
Male
Female
Non-Binary
Undisclosed
Ethnicity
*
Please Select
White
Asian
African American/Black
Hispanic/Latino
Native American
Multi-Racial
Indian
Korean
Time Preference
*
Please Select
Morning 9:30 - 12:30
Afternoon 1:00 - 4:00
Purpose for Taking the Psychological Asessment:
*
Please Select
Applying for Ordination
Application for Associate Membership
Applying for Provisional Membership
Applying to Transfer
Applying to be a Licensed Local Pastor
Applying to be a Certified Candidate
Fitness for Ministry Evaluation
Next Steps
Once your registration is received, you will be sent an email with a list of the forms to complete prior to taking your assessment as well as communication from Clergy Excellence to schedule your assessment.
PAYMENT DETAILS
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Psychological Assessment 40-04200 57710
40-04200 57710
$
250.00
Quantity
1
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9
10
Credit Card
Next Steps
Clergy Excellence will follow up soon with an informational email
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