Spiritual Care Professional Application

Spiritual Care Professional Application
Spiritual Care Professional Membership is for persons who completed four or more units of CPE recognized by the ACPE. Spiritual Care Professionals must also sign an Accountability for Ethical Conduct Policy Form and file it with the national office.

Spiritual Care Professional Membership Benefits include:
•       Listing in the ACPE online directory.

•       Member rates to ACPE conferences and events.

•       An “acpe.edu” email address. .EDU email addresses allow members to take advantage of educational benefits, including discounted and free software and subscriptions.

•       With your ACPE email accounts, you will also have access to web versions of Microsoft Word, Excel, PowerPoint and other programs for free.

•       Access to ACPE’s private online community built on Microsoft Yammer.

•       Networking and Professional Development Opportunities including membership in various Communities of Practice.

•       Subscription to ACPE publications including the Journal of Pastoral Care & Counseling.
Name*

PrefixFirst NameMiddle NameLast NameSuffix
Center/Company (if applicable)
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Work Phone*

Area CodePhone Number
Home Phone

Area CodePhone Number
Cell Phone

Area CodePhone Number
Email*
example@example.com
Include your email address to be sent a login and password to the Members Only section of the ACPE website. Home and cell phone numbers are not published in ACPE directories or listed on the webpage.
ACPE Account
If you know your account number, please provide it:
Membership Type

RenewingFirst Time Applicant
Provide us with a history of your CPE units to the best of your knowledge.*
Did you have a different name at the time you took your unit(s)? If yes, please provide it:
Please upload a headshot

Browse Files

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Optional Information

The ACPE is committed to attracting, developing, and advancing the most talented caregivers and students regardless of their race, sexual orientation, spiritual/religious practices, age, gender, disability status and any other dimension of diversity. The information below is not required. It is collected for statistical purposes to track the association’s progress of achieving a diverse membership. Thank you for taking the time to tell us about yourself!
Gender

FemaleGender Non-conformingGender QueerIntersexedMaleTransgender
Birthday

MonthDayYear
Date
Faith Group
Check all that apply

American Indian and Alaska NativeAsian or Southeast AsianBlack or African DescentHispanic or LatinoNative Hawaiian and Other Pacific IslanderWhite or CaucasianOther
Don’t forget to complete the Accountability for Ethical Conduct Policy Report Form to complete your application!
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