Lay License Application

Lay License Application

This application is for Worship Leaders, Eucharistic Ministers, and Eucharistic Visitors. Your completed Lay Licensing Application and materials will be reviewed by the Canon for Leadership Development, Mr. Russ Tripi. Upon approval, a certificate with an expiration date will be emailed to you to share with your parish administrator. Licenses must be renewed every three years.
Stop! Before Proceeding, See Additional Materials Required!

Before completing this form, please ensure you have the following documents ready to upload: A letter of support/confirmation from your Rector, Priest, or Senior Warden; certificates of completion for the required Safe Church training modules taken within the past three years (see the bottom of this form for the list of required modules); Proof of a completed criminal background check (Eucharistic Visitors only)
Today's Date

MonthDayYear
Date
Which Lay License Are You Applying For?*

Eucharistic MinisterEucharistic VisitorWorship Leader
Is this a new license or renewal?*

This is a new licenseI am renewing my license
Name:*

First NameLast Name
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your Phone Number:*
Your Email:*
example@example.com
Faith Community:*
Faith Community Office Email:*
example@example.com
A Eucharistic Visitor is required to complete a criminal background check every three years. This can be completed through Praesidium for a modest fee. Once completed, please upload proof of the background check as part of your certification documentation.*

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Date of Training:*

MonthDayYear
Date
Location of Training:*
Name of Trainer:*

PrefixFirst NameLast Name
Upload a letter from your Rector, Priest, or Senior Warden confirming that your training has taken place and that you are a confirmed/received communicant in good standing.*

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What motivates you to pursue this lay license?*
Please provide some feedback on the training:*
Have you received anti-racism training through the Episcopal Diocese of Ohio?*

YesNo, but agree to become certified within the next three yearsOther
What else can the diocesan office do to support you in this ministry?*
Would you be interested in serving as a presenter for future trainings in this ministry for nearby churches in your area?*

YesNoMaybe
All applicants for lay licensing must be up-to-date with their Safe Church training.

Listed below are the required modules for completion. Please upload relevant certificates to confirm compliance with each of the following modules. Training must be repeated every three years.

Information on how to access training can be found here: https://www.dohio.org/ministries/safe-church/trainingcertification
Safe Church Universal Training: "Healthy Boundaries"*

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Safe Church Universal Training: "Inclusion"*

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Safe Church Universal Training: "Power and Relationships"*

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Safe Church Universal Training: "Bullying"*

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Safe Church Universal Training: "Abuse & Neglect"*

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Safe Church Universal Training: "Mandated Reporter"*

*Required for Eucharistic Visitors only.
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Lay License Application

Stop! Before Proceeding, See Additional Materials Required!