Application for Clinical Pastoral Education
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Faith Group Affiliation
*
Graduate School Degree(s)/Date(s)
*
Prior CPE Dates/Center(s)/Educator(s) - if applicable
Applying for:
*
Spring Internship—1 unit
Summer Internship—1 unit
Fall Internship—1 unit
Residency—3 units (Prior completion of 1 unit is required)
Upload your signed ACPE application face sheet and essays, including resume, helping incident, and final evaluations from any previous CPE units.
*
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