Protest Chaplain Training Application

Protest Chaplain Training Application

Use this form to apply for the online movement chaplain training being sponsored by the Wisconsin Council of Churches.
Training will be held online from 6:30-8:30 pm Central on April 13 and 20.

There will be required readings between sessions. Our trainer is the Rev. Anna Golladay of Convergence. Please note: your application does not guarantee selection. Only 20 applicants will be selected; there will be a $50 copay for those enrolled in the class. A limited number of scholarships are available.
Full Name*

PrefixFirst NameLast Name
Current Ministry Site*
Name of organization, congregation or community
Location of Ministry*
City or Town, University
Ministry Role or Title*
Pastor, Campus Min, Religious Ed, Lay Leader...
Phone Number*
Please enter valid #. Mobile preferred.
Email Address*
example@example.com
Signal Handle
@name or phone # - how you are searchable
Have you had any of the following trainings?*

Clinical Pastoral Education (CPE)First Aid and/or CPRStreet Medicine and/or Stop The BleedPoll ChaplainOther
Why are you interested in this opportunity?*
What do you expect to be your #FaithfulNextStep upon completion?*
If selected, your portion of the cost will be $50. Please indicate below your ability and willingness to pay. A limited number of scholarships may be available.*
Your request for a scholarship or contribution towards scholarships WILL NOT factor into acceptance decisions.
Other trainings: I would be interested in a training on...
For information only. Not required.
Please read: Completion of this application does not guarantee selection. Attendance at BOTH nights of training is required. If selected, your portion of the cost will be due before the course begins. We recommend you hold both evenings (April 13 and 20) on your calendar now. We will make decisions by March 30.
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