CFM 216: Discipleship Practicum Application Form

CFM 216: Discipleship Practicum Application Form
Are you a CFM student or a Worship Arts student?
Connect with Dan Haase, CFM Department Chair, to learn how to properly engage the CFM 216 syllabus here before submitting your application.
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Student ID Number
ex. 12345
Email
example@example.com
Academic Advisor

First NameLast Name
Practicum Begin Date

MonthDayYear
Date
Practicum End Date

MonthDayYear
Date
Which semester is your Practicum taking place? (check all that apply)
The Discipleship Certificate requires 2 practica, and this is my:
Practicum Title
Practicum Site Name
Practicum Site Location

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Practicum Site Supervisor

First NameLast Name
Practicum Site Supervisor Contact Number
Please enter a valid phone number.Format: (000) 000-0000.
Practicum Site Supervisor Email
example@example.com
Student Signature
Date

MonthDayYear
Date
Practicum Vision Statement
Identify why you are entering into this discipleship practicum and what you hope to accomplish or learn by the end of your experience.
CFM Objective Completion
Self-select 3-6 of the 9 objectives from page 2 of the syllabus (see chart with academically grounded, spiritually maturing, and practically skilled categories). Construct specific and tangible ways you will address the objectives you've selected ("I know [state objective] will be met when evidenced by...[insert your stated commitment]").
CFM Objective Completion

Under each description, construct specific and tangible ways you will address these objectives ("I know [state objective] will be met when evidenced by...[insert your stated commitment]").
Demonstrate a life of discipleship and spiritual growth as the foundation of effective ministry.
Identify one’s gifts and calling, responding to areas of strength and challenge in preparation for serving the needs of the church and the world.
Respect every person, valuing the diversity of cultures, ethnicities, and traditions within the church.
Minister and teach effectively, integrating theory and scripture into creative practice with integrity, humility, and grace.
Serve collaboratively and compassionately, balancing the needs of others with adequate self-care.
Should be Empty:

CFM 216: Discipleship Practicum Application Form

CFM Objective Completion