Application for Certificate Program – the Center for Prophetic Imagination

Name *

First

Last

We want to know what pronouns you prefer to be called. What are your preferred gender pronouns? Examples: she, he, they

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone

Email *

How did you learn about this program?

Discernment Questions

What is it about the program in Spiritual Direction and Social Transformation that appeals to you? *

What makes this the right time in your life to participate in this program? *

What is your experience with spiritual direction? What do you think of when you hear that term? *

What calls you to the practice of spiritual direction? *

What hopes do you bring into this program? How do you see using spiritual direction in the future? *

This program assumes some basic theological competency. What is your theological education or experience in spiritual communities or churches? *

Financial Matters

Please take a look at the information listed on our Tuition/Fees page before proceeding.

Which amount will you be paying? *

Payment for each module is expected before the module starts.

Alternative arrangements can be worked out as needed. Please contact us for more information.

References and Resume

Please attach a resume or curriculum vitae. If you don't have one, a single page narrative of significant job, volunteer, and other pertinent activities is acceptable. *

Click or drag a file to this area to upload.

Please list two references, including their contact information and the nature of your relationship. *

It is important to us that you read through all of the information about the program before applying, *

I have read through all of the materials provided on this website regarding the Certificate in Spiritual Direction and Social Transformation

I have read and understand the cancellation policy linked below. *

I agree.

If we cancel an individual module or elective due to low enrollment, we will give registered participants a full refund, or they can transfer their payment to another course held within one year of the cancellation date.

If you withdraw 30 or more days prior to the start of a module or elective, you will receive a full refund or a credit towards another module or elective.

If you withdraw less than 30 days before the start of an module or elective, you will receive a 75% refund.

If you withdraw after the start of a module or elective, you will not receive a refund.

Name

Discernment Questions

Financial Matters

Payment for each module is expected before the module starts. Alternative arrangements can be worked out as needed. Please contact us for more information.

References and Resume

Payment for each module is expected before the module starts.

Alternative arrangements can be worked out as needed. Please contact us for more information.