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Application for Certificate in Interfaith Sacred Justice Ministry

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Thank you for your interest in our Interfaith Sacred Justice Ministry Certificate Program. If you are interested in the dual Chaplaincy Program/SJM Program, please complete the dual student application instead. We encourage your thoughtful and reflective completion of this Admissions Application. If you need help or have questions, you are welcome to call Admissions at 510-843-1422 ext. 1 or email admissions@chaplaincyinstitute.org.

Application and Intent to Enroll Fees: There is a $150 non-refundable application fee, as well as a $250 Intent to Enroll fee which will be credited towards your tuition payments upon final enrollment. We presume that the submission of your application indicates a preliminary commitment to enroll if accepted. This fee will be refunded if and only if you are not accepted into the program.

Admissions Interviews: All applications are reviewed by the admissions team. Our Program Director, Rev. Rivka Gevurtz, MDiv., will be in contact with you about an admissions interview on Zoom.

The Application:
- Section 1 Tell Us About Yourself
- Section 2 Reflective Questions
- Section 3 Spiritual Autobiography
- Section 4 Reference Letters
Full Name

PrefixFirst NameLast Name
Pronouns
E-mail:
Phone Number
Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState

Zip Code
Birthdate (optional)
Tell Us About Yourself
Education and Training
High School
Undergraduate Institution Attended (if applicable)
Undergraduate Degree Obtained/Major
Graduate Institution Attended (if applicable)
Graduate Degree/Area of Study
Other Certificates/Trainings with Dates of Completion
Please let us know how you heard about The Chaplaincy Institute
Vocational Experience
Are you currently ordained to ministry? If yes, in what faith tradition and/or denomination were you ordained? When?
Do you have previous experience in religious or spiritual leadership, ministry, or chaplaincy? Describe briefly:
Have you participated in social justice advocacy? Describe the causes and circumstances that have impacted and inspired you to care for marginalized peoples and the planet.
What has been your experience (personal or in an ally capacity) with oppression and its many permutations? Where have you been able to utilize your privileges in solidarity with marginalized communities? How have your own social identities informed your understanding of oppression?
What particular strengths do you feel you bring to sacred justice ministry? In what areas do you feel you most need to grow? What evidence of a call to do sacred justice ministry do you see in yourself?
Please upload your most recent resume/CV as an outline of your professional experience.
Current Resume/CV

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Do you consider yourself to be an artist or creative person? If yes, please let us know more about your creative endeavors by listing and/or describing your participation in visual arts, music (either vocal or instrumental), dance, writing, etc., plus any publications or other recognitions.
We affirm the legislation in 37 states which "bans the box", but also recognize that incarceration and/or conviction of a felony has an impact on your spiritual journey. Answering this question will not preclude your consideration. Have you ever been charged with a felony? If yes, please be ready to talk more about it in your interview.
Do you have special needs and/or different abilities that should be known to our staff?
Spiritual Autobiography
Write a spiritual autobiography. In 5 double-spaced pages, tell us about your spiritual journey. We want to hear the story of your love affair with the Divine, including the ups and downs, wrong turns, and everything in between. Where did you start out? Where are you now? And how did you get here?

Upload your autobiography by clicking below.
Spiritual Autobiography

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Recommendation Letters
Two (2) recommendation letters are required from individuals who are familiar with your spiritual, professional, and/or academic background.

Please send your recommenders this link https://form.jotform.com/chioffice/Recommendation

Please inform them that your application will not be reviewed until their letters are received.

All information received will be kept confidential. Please note that by submitting recommendation letters, you agree to give The Chaplaincy Institute permission to contact your references for any further clarification needed.
Please tell us who to expect Letters of Recommendation from:
I affirm that the information I have provided is true and accurate to the best of my knowledge.
Payment

Application Fee and Enrollment Fee Payment

Sacred Justice Ministry Certificate Application Fee

$150.00

Sacred Justice Ministry Certificate Intent to Enroll Fee

Will be applied as a credit to your tuition

$250.00

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Application for Certificate in Interfaith Sacred Justice Ministry

Tell Us About Yourself

Education and Training

Vocational Experience

Spiritual Autobiography

Recommendation Letters

Payment

Application Fee and Enrollment Fee Payment*

Application Fee and Enrollment Fee Payment